Design: Prospective observational study.

Setting: Single tertiary medical center.

Patients or Participants: Surgical teams were observed while performing surgeries for benign indications.

Interventions: Designated study personnel were assigned to observe surgical procedures performed July-September 2022. Surgical teams were not informed of the purpose of the observation to avoid potential bias. Disposable materials and equipment opened and used during the procedure were documented. Excess supplies were defined as those opened but left unused before being discarded. Costs per item of excess supplies were estimated based on material and equipment costs provided by the hospital.

Measurements and Main Results: 99 surgeries were observed, including laparoscopic (32%), robotic (39%), hysteroscopic (14%), vaginal (11%) and laparotomy procedures (3%). Excess use of surgical supplies was documented in all but one procedure. Raytecs were the most frequently item used in excess, with a total of n=583 opened but unused (average n=5.95 per surgery). They contributed 44.19% of the total cost of excess surgical supplies that reached $19,788 across all surgeries. The most expensive excess item was the Airseal Gas tube™ (Conmed Corp, $77.25 per unit), which was used in excess in n=5 procedures. No significant differences were found in the number of excess supplies across the surgical approaches.

Conclusion: Excess use of disposable materials and equipment is common in minimally invasive benign gynecological surgeries and contributes surgical cost. It is predominantly attributed to opening of inexpensive materials that are left unused during the procedure. Increased awareness of costs and generated waste may reduce excess use of surgical supplies and will be explored in future research.