Granular Analysis Reveals Smart Insufflation to Be Operationally More Efficient and Financially Net Positive Compared to Traditional Insufflation for Laparoscopic Surgery

Abstract

Introduction: Smart insufflation (SI) techniques relying on valve and membrane-free insufflation are increasing in usage. Although considerable literature exists demonstrating the benefits of SI on procedural ease and patient outcomes, there remains a paucity describing the financial impact of these devices. The purpose of this study was to determine the financial and efficiency impact of these devices on the operating room (OR) and inpatient wards of a hospital.

Methods: A discrete event simulation model representing a typical mid-sized North American hospital comparing SI to TI was generated. The National Surgical Quality Improvement (NSQIP) database from 2015 to 2019 was used to populate the model with data supplemented from literature. Outcomes included length of stay (LOS), duration of surgery (DOS), annual procedure volume, profit, return on investment (ROI), and gross profit margin (GPM).

Results: The operational parameters demonstrating favorability of SI to TI were DOS and LOS. DOS savings were 10-32 minutes/case while LOS savings were 0-3 days/case. Implementation of an SI led to an increase in annual throughput of 148 cases (12%). LOS decreased by 189 days (19%). This resulted in an increase in net profit of $104,675 per annum. The ROI of SI over TI device was >1000%.

Conclusion: Despite the initial financial investment being greater, the implementation of SI offsets these expenses and yields significant financial benefits. Our study demonstrates the financial benefits of SI over TI and illustrates how granular operational and financial analysis of technologies are essential to aid in sound healthcare procurement decision making.

Note:
Funding declaration: Research funding to conduct this study was provided by a research innovation grant provided by ConMed Corporation (#IRB 22-0113-C).

Conflict of Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Ethical Approval: Research ethics approval from Mount Sinai Hospital were obtained before the commencement of this study.

Keywords: insufflationAirsealsurgical efficiencyfinancial impact