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[Total laparoscopic hysterectomy. Cost analysis].

M Pittino1, S Facchin, A Rossi

  • 1Unità Operativa di Ostetricia e Ginecologia, Azienda per i Servizi Sanitari n. 4 Medio Friuli, San Daniele del Friuli, Udine.

Minerva Ginecologica
|October 28, 1999
PubMed
Summary

Total laparoscopic hysterectomy using non-disposable instruments is a cost-effective alternative to abdominal or vaginal hysterectomy. This advanced endoscopic gynecological surgery offers significant benefits for patients and hospitals.

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Area of Science:

  • Gynecological Surgery
  • Minimally Invasive Procedures
  • Surgical Technology

Background:

  • Total laparoscopic hysterectomy represents an advanced endoscopic gynecological surgery.
  • Evaluating the cost-effectiveness of laparoscopic hysterectomy compared to abdominal and vaginal approaches is crucial.

Purpose of the Study:

  • To compare the costs and hospital charges of total laparoscopic hysterectomy (TLH) with total abdominal hysterectomy (TAH) and vaginal hysterectomy (VH).
  • To analyze the specific costs associated with instruments used in laparoscopic procedures, such as linear staplers versus bipolar coagulation devices.

Main Methods:

  • Cost analysis of surgical instruments, specifically linear staplers versus disposable and non-disposable bipolar coagulation instruments.
  • Comparison of total median hospital charges across three hysterectomy methods: abdominal, vaginal, and laparoscopic.

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Main Results:

  • Linear staplers incurred significantly higher median costs (Lire 2,932,304) compared to non-disposable bipolar coagulation instruments (Lire 936,488).
  • Median total hospital charges were highest for abdominal hysterectomy (Lire 6,014,448), followed by vaginal hysterectomy (Lire 4,449,617), and lowest for laparoscopic hysterectomy with non-disposable supplies (Lire 4,078,000).

Conclusions:

  • Bipolar coagulation is confirmed as a reliable hemostasis method in laparoscopic surgery.
  • Laparoscopic hysterectomy is a viable and recommended alternative to laparotomy, offering benefits to both patients and healthcare facilities.