{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:02:32Z","timestamp":1790071352532,"version":"4.0.1"},"reference-count":24,"publisher":"Wiley","issue":"1-2","license":[{"start":{"date-parts":[[2016,11,23]],"date-time":"2016-11-23T00:00:00Z","timestamp":1479859200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The quality of instruments and surgical expertise in minimally invasive surgery has developed markedly in the last two decades. Attention is now being turned to ways to allow surgeons to adopt more cost\u2010effective and environmental\u2010friendly approaches. This review explores current evidence on the cost and environmental impact of reusable versus single\u2010use instruments. In addition, we aim to compare their quality, functionality and associated clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The Medline and EMBASE databases were searched for relevant literature from January 2000 to May 2015. Subject headings were Equipment Reuse\/, Disposable Equipment\/, Cholecystectomy\/, Laparoscopic\/, Laparoscopy\/, Surgical Instruments\/, Medical Waste Disposal\/, Waste Management\/, Medical Waste\/, Environmental Sustainability\/ and Sterilization\/.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There are few objective comparative analyses between single\u2010use versus reusable instruments. Current evidence suggests that limiting use of disposal instruments to necessity may hold both economical and environmental advantages. Theoretical advantages of single\u2010use instruments in quality, safety, sterility, ease of use and importantly patient outcomes have rarely been examined. Cost\u2010saving methods, environmental\u2010friendly methods, global operative costs, hidden costs, sterilization methods and quality assurance systems vary greatly between studies making it difficult to gain an overview of the comparison between single\u2010use and reusable instruments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Further examination of cost comparisons between disposable and reusable instruments is necessary while externalized environmental costs, instrument function and safety are also important to consider in future studies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.13856","type":"journal-article","created":{"date-parts":[[2016,11,23]],"date-time":"2016-11-23T09:48:46Z","timestamp":1479894526000},"page":"28-33","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":93,"title":["Systematic review of reusable versus disposable laparoscopic instruments: costs and safety"],"prefix":"10.1111","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6172-3497","authenticated-orcid":false,"given":"Joey","family":"Siu","sequence":"first","affiliation":[{"name":"Department of Surgery, South Auckland Clinical Campus The University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew G.","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Surgery, South Auckland Clinical Campus The University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew D.","family":"MacCormick","sequence":"additional","affiliation":[{"name":"Department of Surgery, South Auckland Clinical Campus The University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,11,23]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2006.0077"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/109264202762252677"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11367-013-0547-7"},{"key":"e_1_2_5_5_1","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1177\/000313480206800516","article-title":"A study of added costs of laparoscopic cholecystectomy based on surgery preference cards","volume":"68","author":"Allen JW","year":"2002","journal-title":"Am. 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