Assessing the costs and consequences of laparoscopic vs. open methods of groin hernia repair: a systematic review.
BACKGROUND
We aimed to provide unbiased estimates of cost-effectiveness by systematically reviewing published cost and cost-effectiveness data derived from studies with rigorous designs that compared laparoscopic with open groin hernia repair.


METHODS
Studies reporting costs and outcomes were identified as part of a systematic review of randomized controlled trials comparing laparoscopic with open repair. The quality of the included studies was assessed against a standard checklist. Cost per recurrence avoided and cost per additional day at usual activities were estimated.


RESULTS
Fourteen studies were identified. Laparoscopic repair was less efficient than open mesh repair in terms of avoiding recurrences, avoided but it had a modest cost per additional day back at usual activities. Laparoscopic repair is more likely to be efficient when compared with open nonmesh repair.


CONCLUSIONS
The type of open repair with which laparoscopic repair is compared influences its cost-effectiveness. The earlier return to usual activities provided by laparoscopic repair may make it worthwhile in some circumstances.
Vale
L
L
Health Economics Research Unit, University of Aberdeen, Polworth Building, Fosterhill, AB25 2ZD, Aberdeen, Scotland. l.vale@abdn.ac.uk
Ludbrook
A
A
Grant
A
A
D003362:Cost-Benefit Analysis; D004209:Disposable Equipment / Q000191:economics; D006119:Groin / Q000473:pathology / Q000601:surgery*; D006552:Hernia, Inguinal / Q000191:economics* / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000191:economics*; D016032:Randomized Controlled Trials as Topic; D013523:Surgical Equipment / Q000191:economics