In modern healthcare, innovation often takes centre stage: robotics, AI diagnostics, and advanced imaging, but some of the most impactful changes come from rethinking the fundamentals. Among them is a deceptively simple idea: what if hospitals refurbished more of their surgical instruments instead of replacing them?
Every day, hospitals throughout the UK retire surgical instruments, not because they are beyond repair, but because they are showing minor wear, cosmetic damage, or are less effective than they previously were. Meanwhile, healthcare budgets tighten, surgical waste volumes grow, and hospital teams are forced to do more with less.
Whilst it is fairly obvious that refurbishing surgical instruments instead of replacing them has an environmental benefit, what about the financial implications? This article dives deeper into the economic case for refurbishing surgical instruments.
The Cost of “New by Default”
Surgical instruments are a critical and costly part of the operating theatre. High-quality instruments such as laparoscopic scissors, forceps, retractors, and orthopaedic tools often cost hundreds, if not thousands, of pounds per unit. Over time, these costs multiply significantly, particularly in high-volume departments like orthopaedics or general surgery.
It has been reported that approximately 80% of surgical instruments sold in the UK are now single-use. The adoption of single-use instruments has increased significantly, driven largely by their perceived benefits of convenience. This uptake of single-use has escalated the financial cost of instruments, with studies finding that a single-use set can cost anywhere between 7 and 24 times more than using reusable instruments¹, increasing the financial burden on hospitals. Not only do single-use instruments cost more, but a study declares that reusables do not compromise patient or staff safety any more so than single-use Instruments¹.
A systematic review of surgical instruments in theatre could uncover significant savings, but could incorporating refurbishment of reusable instruments unlock even greater value?
What Is Refurbishment, and Why Should Hospitals Care?
The refurbishment of surgical instruments is not a workaround; it is a regulated, quality-assured process that requires surgical instrument companies to have a range of certifications. It involves professionally restoring surgical instruments to near-original condition. Depending on the instrument, refurbishment may include regrinding and sharpening edges, realigning or re-tensioning joints, polishing surfaces, replacing worn components, and conducting thorough quality assurance testing.
This process is governed by strict regulatory standards such as ISO 13485 (medical device quality management systems), and overseen by regulatory bodies, including the MHRA in the UK. Certified surgical instrument refurbishment companies provide full traceability, often alongside warranties that match or exceed those for new instruments.
In other words, refurbished does not mean second-rate. It means renewed. Imagine your car has a worn-out brake pad or a scratched door. Instead of replacing the part or getting it repaired, you decide to scrap the entire vehicle and buy a brand new one. That logic can be applied to surgical instruments; rather than refurbishing high-quality instruments, sharpening, realigning, or repairing them, they’re discarded and replaced with new or single-use alternatives.
Just as it’s more economical and sustainable to maintain a car over time, it makes far more sense to restore surgical instruments that are built to last, especially when refurbishment can cost a fraction of replacement.
The Economic Evidence
A growing body of research, case studies, and pilot programmes has demonstrated that refurbishment can reduce the cost of surgical instruments, saving hospitals thousands of pounds in the process.
One study across three hospital sites in the Netherlands showed that refurbishing 945 instruments achieved savings of €38,000 over the cost of buying new2. The paper concluded by stating: “the repair and refurbishment of surgical instruments, instead of replacing with new instruments, shows to have the most potential in terms of cost reduction”2.
The savings can be replicated in UK NHS theatres too. Figure 1 demonstrates some real-world examples of how much it costs to have an instrument refurbished compared to its typical replacement price.
| Product | Repair Required | Cost to Refurbish | Cost to Replace | Saving per Unit |
|---|---|---|---|---|
| Mayo Scissors | Blades are blunt and require sharpening | £2.16 | £45.83 | £43.67 |
| Diathermy Forceps | Insulation is cracked, requires replacing | £10.73 | £87.49 | £76.76 |
| Osteotome with a Tufnol Handle | Chipped tip requires edge regrind | £3.58 | £178.33 | £174.75 |
| Mayo Hegar Needle Holder | Chipped TC Inserts, require new inserts | £16.45 | £80.83 | £64.38 |
| Spencer Wells Artery Forceps | Bent and twisted tips, need realigning | £2.16 | £41.66 | £39.50 |
Figure 1: Cost to Refurbish is Uniplex refurbishment prices, Cost to Replace taken from an alternate NHS Supplier
Figure 1 shows how much can be saved, and when applied to instrument trays with 100+ items, the scale of savings is substantial. Yet despite this, many hospitals still replace rather than refurbish reusable surgical tools. What are the typical barriers that are stopping all NHS hospitals from refurbishing their surgical instruments?
Addressing the Common Concerns
When a hospital considers moving away from procurement as usual toward a repair and refurbishment approach, questions are bound to emerge. Among the top concerns are whether refurbished reusable instruments meet the same safety and performance standards, how reliably quality can be maintained, and whether integrating reuse or repair will interrupt the flow of operations.
Is it safe? Surgical instrument refurbishment performed by accredited providers under regulatory frameworks (such as those with ISO 13485, who are registered on the NHS Supply Chain Surgical Instruments framework) delivers safety and quality on par with new instruments. Many providers offer warranties, batch traceability, and stringent quality assurance processes.
Could it cause delays? In some cases, refurbishment can actually be quicker than replacing, with some instrument suppliers having lead times in the weeks or months. Refurbishment programmes can be built around existing surgical schedules, with instruments sent for restoration on a rolling basis and returned within days. Uniplex operates a standard 5-day turnaround, but as fast as 48-hour turnarounds when required.
Is it worth the effort? Yes. In many trusts or hospitals, once systems are established, refurbishment becomes a standard procurement pathway. The administrative burden can be comparable or even lower than that of managing entirely new purchases, especially when savings and reduced lead times are factored in.
Implementation: Where to Begin
For hospitals that are new to surgical instrument refurbishments, the process couldn’t be simpler. First of all, an audit of your current surgical instruments would be beneficial; this will highlight the condition and quantity of your current inventory. Some repair companies will help audit your inventory and make a professional assessment of the instruments, while at the same time educating the in-house team on what to look out for.
The next stage would be to engage with an accredited surgical instrument repair company. An accredited service will have ISO13485, ISO9001, and from an environmental perspective is advantageous to have ISO14001. A key aspect is that the repair company will be on the NHS Supply Chain Surgical Instrument Framework. This means the due diligence has been performed on the company to ensure they provide a quality service.
A great way to ensure the company provides high-quality repairs is to ask them to perform a small free-of-charge trial. Sending a few basic instruments such as scissors, needle holders and artery forceps will test the company’s turnaround time, communication and quality of the repair.
Sometimes it can be difficult to compare companies on the price of instrument repairs, as not all repairs are equal. For example, a needle holder may need to be aligned or may need new inserts. Both are repairing the needle holder, but with slightly different prices. Therefore, it’s good to provide very specific examples for quotes, including:
– Mayo Needle Holder, chipped TC inserts. The inserts require replacing
– Bipolar Forceps, cracked insulation. Insulation needs recoating
– Micro Scissor, missing spring. A replacement spring is required
These examples remove the ambiguity around the repair and allows the repair company to offer accurate pricing that can be compared across companies.
Conclusion: Surgical Instrument Refurbishment Just Makes Sense
Refurbishing surgical instruments is not a compromise. It’s a decision grounded in economic logic and environmental responsibility, which has been reinforced in clinical papers. By refurbishing instead of replacing, hospitals can save tens or even hundreds of thousands of pounds annually, without sacrificing safety, quality or performance.
At a time when NHS theatre budgets are under intense pressure and sustainability targets loom large, refurbishment is a practical solution hiding in plain sight.
It’s time to stop throwing away and start refurbishing.
If you would like to begin refurbishing your surgical instruments, Uniplex offers a comprehensive service including repairing general instruments, specialist instruments, micro instruments, laparoscopic instruments, arthroscopic instruments and diathermy instrumentation, along with rigid endoscopes, hoses and power tools.
Get in touch today:
info@uniplexuk.com
0114 241 3410
https://uniplexuk.com/contact-us/
References
1) Buddhdev, P., Tebby, J., Black, P., Harding, D., Kendall, J., & Shah, H. (2024). Improving Theatre Productivity by Digitising Surgical Equipment Repairs. Cureus, 6, 6-16.
2) Demoulin, L., Kesteloot, K., & Penninckx, F. (1996, 05). A cost comparison of disposable vs reusable instruments in laparoscopic cholecystectomy. Surgical Endoscopy, 520-525.
3) Van Straten, B., Dankelman, J., Van Der Eijk, A., & Horeman, T. (2021). A Circular Healthcare Economy; a feasibility study to reduce surgical stainless steel waste. Sustainable Production and Consumption, 27, 169-175.
