MP69-06 THE IMPACT OF SINGLE-USE DIGITAL FLEXIBLE CYSTOSCOPE FOR DOUBLE J REMOVAL ON HOSPITAL COSTS AND WORK ORGANIZATION IN DIFFERENT HEALTH SYSTEMS WORLDWIDE: A MULTICENTRIC EVALUATION

Abstract

INTRODUCTION AND OBJECTIVE: Isiris is a single-use digital flexible cystoscope that allows JJ removal outside of a dedicated endoscopy room (EnR) or operatory room (OR). The main challenge regarding this new technology is its impact on the cost. Since this endoscope is single-use, it does not require a dedicated place for stent removal, cleaning and storage, the only direct costs are the one of IsirisTM itself. Aim of this study was to conduct a multicentric evaluation of the costs and criticalities of JJ removal procedure performed with IsirisTM in different hospitals and health systems, as compared to other JJ removal procedures. METHOD(S): After gathering several institutions worldwide with experience on Isiris, we performed an analysis of the costs related to JJ removal with Isiris, according to the different hospital settings and health systems, and compared to the traditional reusable equipment used in each institution. The cost evaluation included the cost of instrument; EnR/OR occupancy; medical personnel; instrument elimination; maintenance, repairs, decontamination and sterilization of reusable device. RESULT(S): Table 1 shows the cost estimates per JJ removal in the institutions included in study. The main factor affecting the costs of the procedure was OR/EnR occupancy (from 250 to 1.125 for 30'). Decontamination and sterilization accounted for a small part of total costs but might affect the lifespan of reusable instruments. IsirisTM was more rentable in institutions where JJ removal is usually performed in the EnR/OR, allowing to perform the procedure in outpatient clinic, with a significant saving of money (from 41 to 1.140 per procedure) and EnR/OR time that could be dedicated to other activities. Despite the fact that in the only institution where JJ removal is done in outpatient clinics with reusable scopes there was a slight cost benefit in favor of reusable material, Isiris provides that a sufficient number of cystoscopes is always available to guarantee an effective turnover. CONCLUSION(S): IsirisTM leads to significant cost benefit in the institutions where JJ removal is routinely performed in EnR/OR, both in terms of money saved and EnR/OR time saved for other procedures. (Figure Presented).