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Published on: December 23, 2022
Long-term cost-minimization analysis comparing laparoscopic with open (Lichtenstein) inguinal hernia repair
A Eklund1, P Carlsson, A Rosenblad
1Department of Surgery, Central Hospital, Västerås, Sweden. arne.eklund@ltv.se
The British Journal of Surgery
|February 27, 2010
Summary
Laparoscopic inguinal hernia repair is slightly more expensive than open repair over five years. This analysis includes costs for complications and community impact, showing a small but significant overall cost increase for the laparoscopic approach.
Area of Science:
- Surgical innovation and cost-effectiveness analysis.
- Hernia repair techniques and outcomes.
Background:
- Laparoscopic surgery is a novel approach for inguinal hernia repair.
- Evaluating the long-term economic implications of laparoscopic versus open repair is crucial.
Purpose of the Study:
- To conduct a cost-minimization analysis comparing totally extraperitoneal laparoscopic repair (TEP) with open Lichtenstein repair for primary inguinal hernias.
- To assess long-term costs, including recurrences and complications, over a 5-year follow-up period.
Main Methods:
- A randomized multicenter study involving 1370 male patients with primary inguinal hernias.
- Comparison of totally extraperitoneal laparoscopic repair (TEP) against the Lichtenstein open repair procedure.
- Cost-minimization analysis incorporating hospital, recurrence, complication, and community costs.
Main Results:
- The initial hospital cost for TEP repair was €710.6 higher than Lichtenstein repair (P < 0.001).
- Including 5-year recurrence and complication costs, the TEP cost difference rose to €795.1 (P < 0.001).
- When community costs were factored in, the overall cost difference for TEP decreased to €292.0 (P = 0.024).
Conclusions:
- Laparoscopic inguinal hernia repair demonstrates a small but statistically significant increase in overall costs compared to open repair over a 5-year follow-up.
- The analysis highlights the importance of including long-term complications, reoperations, and community costs in surgical cost-effectiveness studies.