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Application of a New Mesh Fixation Method in Laparoscopic Incisional Hernia Repair

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Open and Laparoscopic Inguinal Hernia Surgery: A Cost Analysis.

Francesco Mongelli¹, Antonjacopo Ferrario di Tor Vajana¹, Maurice FitzGerald¹

¹Department of Surgery, Ospedale Regionale di Bellinzona e Valli, Bellinzona, Switzerland.

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A

|February 27, 2019

Summary

Inguinal hernia repair costs vary by surgical approach. While open Lichtenstein repair is profitable, laparoscopic methods, especially bilateral, result in financial losses despite clinical benefits.

Keywords:

costs groin hernia inguinal repair

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Area of Science:

General Surgery
Health Economics

Background:

Economic reimbursement for inguinal hernia repair in the diagnosis-related group (DRG) era is not well-established.
Factors influencing hospital financial outcomes based on open versus laparoscopic approaches require further investigation.

Purpose of the Study:

To conduct a reliable analysis of in-hospital costs and reimbursements for inguinal hernia surgery.
To compare the financial performance of open Lichtenstein repair versus laparoscopic totally extraperitoneal repair.

Main Methods:

Retrospective analysis of 1-year data for inguinal hernia repairs.
Inclusion of open Lichtenstein (OL), unilateral totally extraperitoneal (UTEP), and bilateral totally extraperitoneal (BTEP) repair groups.
Analysis of demographics, outcomes, costs, and diagnosis-related group (DRG)-based reimbursements.

Main Results:

Average costs: OL (4126 EUR), UTEP (5134 EUR), BTEP (7082 EUR).
Average reimbursements: OL (5486 EUR), UTEP (5252 EUR), BTEP (6555 EUR).
Mean hospital earnings: OL (1360 EUR), UTEP (118 EUR), BTEP (-527 EUR).

Conclusions:

In-hospital costs are higher for laparoscopic inguinal hernia repairs (UTEP, BTEP) compared to open Lichtenstein (OL).
DRG reimbursement adequately covers unilateral hernia repairs, but only the OL approach yields profitable hospital earnings.
The bilateral totally extraperitoneal (BTEP) approach results in an overall financial loss, indicating clinical advantages are not economically compensated.