Cost Analysis of Laparoscopic Hysterectomy and Abdominal Hysterectomy

We reviewed the first 75 laparoscopic hysterectomies performed between December 1992 and June 1995, and compared them with 59 total abdominal hysterectomies (TAHs) done by the same surgeons during the same period. Length of hospital stay, use of supplies, operating time, and actual total costs (fixed, variable) were compared for both procedures. The mean length of stay for laparoscopic hysterectomy was significantly shorter than for TAH (1.2 SD 1.2 days vs 3.4 SD 0.8 days, respectively; t = 12.74, p <0.05). Laparoscopic hysterectomy had higher mean operating room cost than TAH ($823 vs $593), reflecting longer mean operating time (186 SD 51 min vs 105 SD 30 min; t = 11.46, p <0.05) and greater use of supplies. The mean total cost of laparoscopic hysterectomy was $2928 (SD $643) and that of TAH was $2721 (SD $395). The cost difference between procedures, although statistically significant (t = 2.31, p <0.05), amounted to only $207. The length of stay, operating time, and use of supplies for laparoscopic hysterectomy decreased over the time of the study. Laparoscopic hysterectomy can be a cost-effective alternative to TAH once one is beyond the learning curve and if steps are taken to reduce the cost of supplies. Our study is in progress and will consist of approximately 160 laparoscopic hysterectomies when completed. From the preliminary results, we can expect further decreases in operating time that would make the costs of laparoscopic hysterectomy and TAH virtually identical.