A cost and outcome comparison between laparoscopic and Lichtenstein hernia operations in a day-case unit. A randomized prospective study.
BACKGROUND
Laparoscopic hernia repair has often been criticized for its high costs.


METHODS
To compare the costs of laparoscopic and open hernia repair, 40 patients were randomized for either transabdominal laparoscopic or Lichtenstein mesh repair (under local anesthesia) in a day-case surgery unit.


RESULTS
Median operative times for the laparoscopic and open groups were 62 and 65 min, respectively. Postoperative pain was comparable for the two groups. The period before return to normal life was 14 days in the laparoscopic group and 21 days in the open group. The hospital costs were 2051 FIM ($1 US = 4.6 FIM) higher in the laparoscopic group, but the total costs for employed patients (including expenses due to lost work days) were lower.


CONCLUSIONS
Although the Lichtenstein operation is cheaper for the hospital, the total costs for working patients are lower with the laparoscopic technique, when the cost of lost work days is factored into overall expense.
Heikkinen
T J
TJ
Department of Surgery, Oulu University Hospital, SF-90220 Oulu, Finland.
Haukipuro
K
K
Hulkko
A
A
D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000191:economics* / Q000379:methods; D013505:Digestive System Surgical Procedures / Q000191:economics* / Q000379:methods; D005260:Female; D005387:Finland; D006552:Hernia, Inguinal / Q000191:economics* / Q000601:surgery*; D017721:Hospital Costs; D006801:Humans; D010535:Laparoscopy / Q000191:economics* / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013526:Surgical Mesh; D016896:Treatment Outcome