I guess part of the one-off nature is that post-op sterilization isn't cost effective; perhaps you simply can't remove the bits of the previous patient from the

I guess part of the one-off nature is that post-op sterilization isn't cost effective; perhaps you simply can't remove the bits of the previous patient from the tool cheaply enough or without degrading it in some way) to justify not just opening another one. Another point is that this tool (to take an example) offers one huge advantage over a scalpel; it will make both cuts simultaneously, reducing the margin of error. I wouldn't want to hear "Well, we messed up taking the first piece, so we need to do it again on the other side". It HAS to be right first time.