Yalini Vigneswaran

Educating surgeons on intraoperative disposable supply costs during laparoscopic cholecystectomy: a regional health system's experience

BACKGROUND Surgeons play a crucial role in the cost efficiency of the operating room through total operative time, use of supplies, and patient outcomes. This study aimed to examine the effect of surgeon education on disposable supply usage during laparoscopic cholecystectomy. METHODS Surgeons were educated about the cost of disposable equipments without incentives for achieved cost reductions. Surgical supply costs for laparoscopic cholecystectomy in fiscal year (FY) 2013 were compared with FY 2014. RESULTS The average disposable supply cost per laparoscopic cholecystectomy was reduced from

Educating Surgeons May Allow for Reduced Intraoperative Costs for Inguinal Herniorrhaphy

589 (n = 586) in FY 2013 to

Evaluation of Vessel Sealing Performance Among Ultrasonic Devices in a Porcine Model

531 (n = 428) in FY 2014, representing a 10% reduction in supply costs (P < .001). Adjustments included reduction in the use of expensive fascial closure devices, clip appliers, suction irrigators, and specimen retrieval bags. CONCLUSIONS Disposable equipment cost for laparoscopic cholecystectomy can be reduced by surgeon education. These techniques can likely be used to reduce costs in an array of specialties and procedures.

Elderly and octogenarian cohort: Comparable outcomes with nonelderly cohort after open or laparoscopic inguinal hernia repairs.

BACKGROUND Our aim was to determine the impact of surgeon education regarding disposable supply costs to reduce intraoperative costs for a common procedure such as inguinal hernia repair. STUDY DESIGN At the end of the 2013 fiscal year (FY 13), surgeons in our department were provided with information about the cost of disposable equipment and implants used in common general surgery operations. Surgeons who historically had lower supply costs demonstrated individual techniques to their colleagues. No financial incentive or punitive measures were used to encourage behavior change. Surgical supply costs for laparoscopic and open inguinal hernia repair in FY13 were then compared with costs during fiscal year 2014 (FY14) using Mann-Whitney U tests. RESULTS The average cost of laparoscopic inguinal hernia repairs decreased from an average

Peroral endoscopic myotomy: An emerging minimally invasive procedure for achalasia

1,088±473 (±SD) in FY13 (n=258) to

NBME Subject Examination in Surgery Scores Correlate with Surgery Clerkship Clinical Experience

860±441 (n=274) in FY14 after surgeon education, representing a 21.0% reduction in intraoperative costs (p<0.001). The most impactful adjustments to reduce costs included selective use of mesh fixation devices (22.9%) and balloon dissecting trocars (27.6%), reduction in use of disposable scissors (13.8%), and reduction in use of disposable clip appliers (3.7%). Open inguinal hernia costs were reduced from an average (±SD) of

Esophageal Resection for End-Stage Achalasia

315±

The Surgical Outcomes Measurement System Is a Superior Measure of Patient-Centered Outcomes after Hernia Repair

253 in FY13 (n=366) to

Mo1597 Impedance Planimetry as a Diagnostic Tool to Evaluate the Degree of Clinical Lower Esophageal Sphincter Dysfunction

288±

Tu1577 Rectus Abdominis Atrophy After Ventral Abdominal Incisions: Midline Versus Chevron

130 in FY14 (n=286), an 8.6% reduction in cost (p<0.01). In these cases, both avoiding the use of fixation devices and using less expensive mesh implants were identified as significant factors. CONCLUSIONS Surgeon education and empowerment may significantly reduce the cost of disposable equipment in laparoscopic and open inguinal hernia repair. This simple educational technique could prove financially beneficial throughout various procedures and disciplines.