A cost and performance evaluation of disposable and reusable biopsy forceps in GI endoscopy.
BACKGROUND: Biopsy forceps are widely used in gastrointestinal endoscopy, and yet few data exist on the usage and costs associated with disposable versus reusable forceps. METHODS: We prospectively measured the costs and operational performance of disposable and reusable forceps in 200 biopsy sessions; 100 sessions were performed using disposable forceps and 100 sessions were performed using reusable forceps. Total cost per use of the reusable forceps, including acquisition costs plus the costs of reprocessing per established guidelines, was determined. At the end of the study, the reusable forceps were disassembled to determine the cause of mechanical failures. RESULTS: The total cost per use of the disposable forceps was $38. For the reusable forceps, the acquisition cost per forceps was $415 and the total reprocessing cost was $16.56 +/- 0.07 per forceps. For 10, 15 and 20 uses, reusable forceps costs were $58.06, $44.23, and $37.31, respectively. Reusable forceps malfunction at 11 to 15 uses was 5%; at 16 to 20 uses was 25%; and at 21 to 25 uses reached 80% (p < 0.001). Dismantling of the reusable forceps at the end of the study demonstrated coiled sheath kinking, rust in the forceps closure mechanism, bent spikes, and biomaterial contamination. CONCLUSIONS: Up to 15 to 20 uses, disposable and reusable forceps costs were similar. If reusable forceps are used more than 20 times, then they are less expensive. However, in this range of uses, reusable biopsy forceps performance diminishes. With disposable biopsy forceps costing less than $40, cost differences between reusable and disposable forceps are minimal.