Laparoscopy-assisted vaginal hysterectomy: cost analysis and review of initial experience in a community hospital.
During the past 2 years, an increasing number of gynecologic surgeons have performed laparoscopy-assisted vaginal hysterectomy (LAVH) and laparoscopic hysterectomy (LH). Although these procedures have become more common, they are still considered controversial. Many gynecologists question their cost, safety, efficacy, and indications. We reviewed and analyzed the perioperative and postoperative course of ten patients as well as the total cost. The patients who underwent these procedures were compared with ten matched patients who underwent abdominal hysterectomy for similar indications. Compared with control subjects, patients in the laparoscopic group had a shorter hospitalization stay (2.2 days vs 4.2 days), shorter recovery (2 weeks vs 5 weeks), and 28% fewer complications. Although the LAVH took significantly longer than TAH (3.28 hours vs 1.75 hours), the total hospital costs and charges for both procedures were similar. As technology advances and techniques are modified, the laparoscopic approach should reduce hospital costs and charges significantly. The current results suggest that LAVH may eventually be preferred to the TAH approach by physicians and their patients.
Department of Obstetrics and Gynecology, Mount Clemens General Hospital, Mich.
M J
MJ
Messina
M M
MM
Garavaglia
R T
RT
Walsh
G D
GD
Turke
R E
RE
Amenta
D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000191:economics* / Q000295:instrumentation; D010535:Laparoscopy / Q000191:economics; D016896:Treatment Outcome