title: Laparoscopic contralateral groin exploration: is it cost effective?
abstract: BACKGROUND
  Transinguinal laparoscopy offers a safe and effective method for evaluating the contralateral groin during unilateral inguinal hernia repair (UIHR). The purpose of this study is to determine whether laparoscopic contralateral groin exploration (LCGE) is cost effective.
  
  
  METHODS
  A retrospective review of all children who underwent UIHR and LCGE from 2006 to 2007 by a single surgeon was performed. Cost analysis comparing the time to perform the LCGE and time to repair the contralateral patent processus vaginalis (CPPV) to the cost saved by preventing future operation for a contralateral inguinal hernia repair was calculated based on Medicare reimbursement.
  
  
  RESULTS
  Eighty-one patients underwent UIHR with planned LCGE; 78 (96.3%) had successful LCGE; 8 (10.3%) had a CPPV and underwent contralateral open repair. The total cost for the additional time to perform LCGE and repair of the 8 CPPV was $13,080. The total cost for returning for a second operation to repair the contralateral inguinal hernia was $20,440.
  
  
  CONCLUSIONS
  Laparoscopic contralateral groin exploration at the time of unilateral inguinal hernia repair was cost effective.
authors.affiliation: Division of Pediatric Surgery, Kaiser Permanente, Los Angeles Medical Center, Los Angeles, CA 90027, USA. slleemd@yahoo.com
authors.forename: Steven L
authors.initials: SL
authors.lastname: Lee
authors.forename: Roman M
authors.initials: RM
authors.lastname: Sydorak
authors.forename: Stanley T
authors.initials: ST
authors.lastname: Lau
mesh_terms: D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D006552:Hernia, Inguinal / Q000175:diagnosis* / Q000191:economics / Q000601:surgery*; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000191:economics*; D008297:Male; D012189:Retrospective Studies; D014481:United States