Category: Clinical Stones: Equipment (stents, lasers, guidewires, sheaths)
Introduction & Objective :
In most cases, Double-J (DJ) stent removal requires a cystoscope. The use of reusable cystoscope (RC) in this procedure involves some constraints and issues (fragility of the device, non-availability of the scopes during reprocessing and repairs, staff mobilization, cross contamination risks,...).
It has been shown that single-use scopes may offer an interesting alternative to reusable endoscopes with a comparable performance£.
Healthcare organizations and professionals are questioning the economic impact of single-use compared to reusable scopes, considering direct and indirect costs. This study was then performed to evaluate the major cost drivers of removing DJ stent by a reusable flexible cystoscope.
The study is a retrospective multicenter assessment of DJ removal cost by a RC. It was performed by an external consultant and based on key players interviews (urologists, nurses and cleaning agents), carried out in 5 French healthcare structures of intermediate to high activity (100 – 300 removals / year). The cost assessment is based on:
Refer to graph A.
Conclusions : Reprocessing is the main cost driver of using a HLD-reprocessed flexible cystoscope in the DJ removal. It represents on average 81€ (66%) of the mean total cost for removing a stent (123€). This analysis highlights a variability of costs between the different structures studied. This may be explained by the negotiated contracts specific to each individual or group center. This analysis does not include the Endoscopy Room occupancy nor some indirect costs like delays or new appointments due to cystoscopes unavailability.
£: Talso M et al. The new grasper integrated single use flexible cystoscope for double J stent removal: evaluation of image quality, flow and flexibility (2016) WJU Dec 16
Vincent Estrade– Urological surgeon, CH Angoulême, Angoulême, Centre, France
Nadege Penhaleux– Consultant, Alcimed company, Paris, Ile-de-France, France
Didier Bon– Urological surgeon, CH Angoulême, Angoulême, Centre, France
Francois Kleinclauss– Head urological unit, CHRU Besançon, Besançon, Franche-Comte, France