SP 5.14 Surgical Trays on a Diet – A Step Towards Greener Theatres

Aims

Annually about 70,000 inguinal hernias are repaired in the UK. In our trust the same surgical tray containing 71 instruments is used for each repair. On average it costs £1.23 to clean one instrument.

The aim of our project was to survey how many instruments are used during a standard hernia repair to rationalise the number of instruments on a tray. This would save on cleaning costs, resources and time counting instruments in theatre.

Methods

Pictures were taken of trays before and after several elective inguinal hernia repairs, clearly depicting which instruments had been used and which had not. From these the number of unused instruments was estimated and the average cost of cleaning unused instruments calculated.

Based on these results, a new list of proposed instruments on a tray was created and circulated around the general surgery consultants.

Results

It was estimated that about 20 instruments were used per case, and thus 45-50 instruments left unused (63-70%). At an average cost of £1.23 per instrument, approximately £55-60 per case and £220-240 per list (assuming 4 cases/list) is wasted on cleaning unused instruments.

Conclusion

Reducing the number of surgical instruments on trays used for inguinal hernia repairs could lead to significant cost reduction in cleaning fees. More importantly it could save resources as part of the Green Theatres Programme and time counting instruments. The next steps include reducing the trays, re-surveying surgeons to assess if there is a noticeable difference and expand this process to other common operations.