OR industry split on merits of disposable/reusable instruments. (Industry Overview)

Competition among vendors who manufacture reusable minimally-invasive surgical instruments and those who sell disposables is heating up as that market expands due to new laparoscopic and endoscopic procedures.

What type of instrument will dominate the market depends on which vendor is asked. Top manufacturers of reusables--and one manufacturer who sells both reusables and disposables--insist reusables will prevail because they cut medical waste and re-use of instruments costs less overall.

This is in spite of the dramatically higher cost of reusables when they are purchased. Reusable instruments typically cost about seven times more at the outset than their disposable counterparts. But the savings are evident--a mid-size hospital might use an instrument seven times in about a week.

Manufacturers of disposables argue there are a multitude of hidden costs associated with reusables, such as the price of cleaning solution and the staff time required to wash the devices. The intricate instruments are difficult to clean thoroughly, increasing the risk of contamination that can spread infectious disease, they say. The Denver, Colo.-based Assn. of Operating Room Nurses Inc. backs the use of disposables.

In a recent report, AORN detailed the hidden expenses associated with the upkeep of reusables, including an additional $9,000 per year to repair basic tools. An independent surgeon added that disposables do not significantly reduce expenses because instrument costs account for only 2% of all hospital overhead.

Opinion is "very mixed" regarding the disposable/reusable issue, agreed Pat Patterson, editor for OR Manager, a Boulder, Colo.-based monthly newsletter. "There is a renewed interest in reusables because of the environmental issues. But it really depends a lot on surgeon preference. Some like disposables because they are constantly sharp, and they don't have to worry about cleaning them, but there doesn't seem to be a clear-cut answer," Patterson said.

A subsidiary of Bristol-Myers Squibb Co., the $130-million-per-year Linvatec Corp, Largo, Fla., manufactures 75% reusables and 25% disposables. Disposable instrument sales have increased since their introduction by the company about two years ago. In 1991, disposables accounted for less than 1% of all sales, doubling to 2% in 1992, and expected to hit 10% to 15% this year. But so far, demand has focused on disposable scissors, trocars and clip appliers because it is more critical that …