Surgical procedures are costly due to staffing, medication use and processing and maintenance of surgical equipment.  Surgical procedures involve a varying quantity of instrumentation depending on several factors including the degree of difficulty of the procedure and the individual surgeon’s needs and preferences.  Most facilities process unused surgical tools wasting labor and costs.   Trimming costs while maintaining quality of care is a constant challenge in healthcare.   This review discusses utilizing lean methodology to discover waste with surgical tools, implementing changes to common surgical tools and the feasibility of incorporating disposable tools.