Background

Laparoscopic staplers play a critical role in bariatric surgery; however, their high costs can significantly impact the overall procedure cost. We aimed to compare the clinical outcomes and operating room costs of 3 different commercially available staplers.

Methods

We conducted a retrospective single-institution analysis of all primary laparoscopic sleeve gastrectomy operations performed from January 2020 to December 2023. Operating room costs were calculated for each operating by summing the costs of the stapler body, stapler reloads, staple line reinforcements, clip appliers, and a fixed supply cost for other materials. We used multivariable linear regression to adjust for preoperative characteristics and calculated differences in operating room costs between the 3 staplers.

Results

Results:325 cases were performed with stapler A, 114 with stapler B, and 108 with stapler C, with no significant differences in preoperative characteristics. Stapler B was associated with a total operating room cost difference of -$795 (95% CI: -878 to -713) compared to stapler A, and stapler C was associated with a cost difference of -$66 (95% CI: -149 to 17) compared to stapler A. There were no statistically significant differences in the rates of reoperation or readmission, and no clinically meaningful differences in the length of stay or %EWL at 1 month.

Conclusions

Stapler B was associated with significant cost savings compared to staplers A and C, with similar safety and efficacy. Surgeons should consider adopting cost-reduction strategies such as using reusable clip appliers, judicious usage of staple line reinforcement material, and choosing less costly stapler devices.