Laparoscopic versus open appendectomy in children: the effect of surgical technique on healthcare costs

Area of Science:

• Pediatric Surgery
• Health Economics
• Minimally Invasive Procedures

Background:

• Healthcare systems face challenges in reducing costs while maintaining quality of care.
• Appendectomy is a common pediatric surgical procedure.
• Comparing surgical approaches is crucial for optimizing healthcare resource allocation.

Purpose of the Study:

• To compare hospital charges between laparoscopic appendectomy (LA) and open appendectomy (OA) in pediatric patients.
• To analyze costs associated with perforated and nonperforated appendicitis for both surgical techniques.
• To evaluate the economic impact of different appendectomy methods in pediatric care.

Main Methods:

• Retrospective review of 264 pediatric appendectomies performed between 2007 and 2013 at a single academic center.
• Subgroup analysis of charges and costs for perforated and nonperforated cases.
• Comparison of laparoscopic appendectomy (LA) versus open appendectomy (OA) outcomes.

Main Results:

• Laparoscopic appendectomy (LA) was performed in 73.9% of cases.
• LA was associated with significantly higher surgical supply, operating room, and total hospital charges compared to open appendectomy (OA).
• Facility surgical supply costs were approximately $1,000 higher for LA in both perforated and nonperforated appendicitis groups, with comparable length of stay and complication rates.

Conclusions:

• Laparoscopic appendectomy (LA) in pediatric patients results in higher surgical costs and charges than open appendectomy (OA) without demonstrable improvements in outcomes.
• Further research should focus on cost-reduction strategies for laparoscopic procedures in appendicitis treatment.
• The findings suggest a need to investigate the economic efficiency of LA in pediatric appendectomies.