OBJECTIVES: To define the incremental benefits concerning the routinely implementation of high-energy devices (HEDs) with respect to standard monopolar/bipolar ones, assuming the hospital perspective, within different surgical settings.

METHODS: A Health Technology Assessment was conducted in 2021 in Italy. The nine EUnetHTA Core Model dimensions were deployed considering: i) literature evidence, to define efficacy and efficiency indicators; ii) administration of qualitative questionnaires to 23 healthcare professionals based on a 7 item Likert scale, from -3 to +3; and iii) quantitative tools useful for the clinical pathway economic evaluation, the budget impact analysis, and the definition of the organizational and accessibility advantages, in terms of time/procedures savings.

RESULTS: Literature declared a decrease in operating time and length of stay, using HEDs, in most surgical settings.

From an economic perspective, an advantage per patient is reported in most surgical settings, with the solely exception of cholecystectomy, colorectal and esophago-gastric surgeries, thus leading to a general modification of costs per patient ranging from +0.81% to -3.14%. While HEDs would lead to a marginal investment for the conduction of 178,619 surgeries (from +0.43% to +0.78%), their routinely implementation would generate significant organizational savings, and an overall improvement in the accessibility to care (+9%).

Healthcare professionals’ perceptions confirmed the superiority of HEDs with respect to standard devices, declaring a better safety (1.10 vs 0.22, p-value=0.022) and effectiveness profile (1.19 vs -0.10, p-value=0.004). In addition, they declared the potentialities of HED to improve patients’ quality of life (1.09 vs 0.22, p-value=0.002) and satisfaction (1.17 vs 0.35, p-value=0.005), as well as their capability to optimize both the patients’ post-operative recovery (1.22 vs 0.26, p-value=0.001) and pain (1.04 vs 0.09, p-value=0.001).

CONCLUSIONS: Results showed the strategic relevance related to HEDs routinely implementation in the surgical practice, demonstrating their hospital economic and organizational sustainability, with important advantages for patients.