title: Financial analysis of needlescopic versus open adrenalectomy.
abstract: OBJECTIVE
  Needlescopic adrenalectomy, partially incorporating 2 mm. instrumentation, is currently our preferred technique for transperitoneal endoscopic adrenalectomy. Although this minimally invasive technique results in decreased morbidity and shorter hospital stay, to our knowledge financial implications vis-à-vis open adrenalectomy have not been elucidated. We retrospectively compared the costs of needlescopic adrenalectomy to traditional open adrenalectomy.
  
  
  METHODS
  From September 1997 through March 1998, 15 patients underwent needlescopic adrenalectomy. Financial records of these patients were compared to those of 15 contemporary patients undergoing open adrenalectomy between January 1995 and May 1997. Adrenal pathology and tumor size were comparable between the 2 groups. Yearly costs were adjusted for inflation to 1998 dollars using a 4% annual rate. Needlescopic financial data are expressed as a ratio of open adrenalectomy costs, which are expressed as a unit of 1.
  
  
  RESULTS
  Overall, needlescopic adrenalectomy resulted in a 17.9% decrease in total hospital costs compared to open adrenalectomy. While the needlescopic approach was associated with an 18.1% increase in intraoperative costs, postoperative costs were 63.4% lower.
  
  
  CONCLUSIONS
  These data demonstrate that in addition to providing a shorter hospital stay, decreased morbidity and quicker recovery, needlescopic adrenalectomy also is 17.9% less expensive than open adrenalectomy.
authors.affiliation: Section of Laparoscopic and Minimally Invasive Surgery, Department of Urology, The Cleveland Clinic Foundation, Ohio 44195, USA.
authors.forename: M G
authors.initials: MG
authors.lastname: Hobart
authors.forename: I S
authors.initials: IS
authors.lastname: Gill
authors.forename: D
authors.initials: D
authors.lastname: Schweizer
authors.forename: E L
authors.initials: EL
authors.lastname: Bravo
mesh_terms: D000315:Adrenalectomy / Q000191:economics* / Q000379:methods*; D003365:Costs and Cost Analysis; D019723:Endoscopes; D004724:Endoscopy / Q000191:economics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles