OBJECTIVES: Surgical treatment of colon cancer requires resection of the tumor mass and formation of anastomosis, such as a latero-lateral. Two common methods to construct an anastomosis are the use of staplers (SA) and hand suturing (HA) (MacRae, 1998; Lustosa, 2002). Our objective was to compare costs and resources for both surgery techniques to assess the potential cost-savings due to surgery time reduction, faster recovery and less complications by the adoption of staplers, under the public payer perspective, in Brazil. METHODS: A decision tree was developed to compare costs and resources for SA versus HA surgical techniques, based on Brazilian guidelines for HTA (Vianna, 2007). Similar efficacy was assumed based on CHOY, 2009, and a panel of specialists was conducted to obtain the local practice. Only direct medical costs (anesthesia drugs, physician fees, hospital length-of-stay (LOS) and materials) were considered based on public lists (SIMPRO, 2009; CBHPM 5th edition). One-month timeframe was considered, based on intra and post-operative periods; consequently a discount rate was not necessary. One-way sensitivity analyses were performed to assess the robustness of the results. RESULTS: Total costs were 1.5% higher for SA than HA (R$7498 versus R$7389), because of stapler’s costs (R$ 1,992 versus R$ 39 for suture). However, SA technique allowed the reduction on operating room costs due to reduction of 2 hours on surgery (4 versus 6 hours), anesthesia drugs and oxygen (R$ 4,009 versus R$4574; 12% of reduction). The SA procedure, also, reduced the LOS (6 versus 8 days; R$1481 versus R$2715) and the complication costs with fistulas and intracavitary abscess (R$15.19 versus R$60.49). CONCLUSIONS: Findings suggest SA technique as a safety and effective choice for colon cancer surgeries, compared with HA, that can reduce use of resources that could offset stapler’s costs, under Brazilian public payer perspective.