Reusable Vessel Sealing Device Can Significantly Reduce Medical Costs Compared to Disposable Device in Modified Total Neck Dissection

Abstract

Vessel sealing devices have been described to be effective, allowing to perform procedures with reduced blood loss and shorter operative times in head and neck surgery. Since the traditional vessel sealing devices are all disposable and expensive, there are not often used even in advanced cancer surgery in terms of cost. On the other hand, ‘marClampCut IQ’ (KLS Martin, Tuttlingen, Germany) is a new reusable vessel sealing device. In this clinical study, a traditional disposable device ‘LigaSure small jaw’ and a reusable device ‘marClampCut IQ’ were particularly compared regarding medical expenses and efficacy in modified total neck dissection. Between October 2014 and April 2020, modified total neck dissections were performed using the ‘LigaSure small jaw’ for 56 patients aged from 26y/o to 88y/o (median:66.0y/o). The ‘marClampCut IQ’ was mainly used between November 2018 and April 2020 for 64 modified total neck dissections in patients aged from 31y/o to 91y/o (median:70.5y/o). The amount of blood loss was significantly more in the ‘LigaSure small jaw’ group than in the ‘marClampCut IQ’ group (U-test, P = 0.006). There were no significant differences in age and operation time between the ‘LigaSure small jaw’ group and the ‘marClampCut IQ’ group. When calculated based on the list price in Japan, ‘LigaSure small jaw’ costed $1,000 each; on the other hand, ‘marClampCut IQ’ costed $240 per operation. We found that we could save $760 per operation using ‘marClampCut IQ’. The new reusable device ‘marClampCut IQ’ provided similar clinical efficacy and safety with a highly reduced cost when compared to the disposable device ‘LigaSure small jaw’ in this clinical study of modified total neck dissection.