title: A cost-analysis comparison of laparoscopic radical prostatectomy versus open radical prostatectomy: the McMaster Institute of Urology experience.
abstract: BACKGROUND
  The objective of this study was to identify and compare the costs of laparoscopic radical prostatectomy (LRP) and radical retropubic prostatectomy (RRP) at our centre.
  
  
  METHODS
  We conducted a retrospective chart review of our first 70 consecutive LRP cases and 70 consecutive RRP cases at St. Joseph's Healthcare in Hamilton, Ontario, Canada. We performed cost analysis, including operating room costs, disposable instruments, blood transfusions, analgesic requirements and length of hospital stay. Overall expenses were then analyzed and compared.
  
  
  RESULTS
  Preoperative patient demographics and disease stages were comparable between the LRP and RRP groups. On a per procedure basis, large discrepancies were found in mean disposable instrument costs (LRP = $659.18 vs. RRP = $236.59), operating room costs (LRP = $4278.00 vs. RRP = $3139.00), mean cost of blood transfusions (LRP = $21.00 vs. RRP = $394.34), mean analgesia requirements (LRP = $12.94 vs. RRP = $41.06) and mean hospital stay bed costs (LRP = $3690.00 vs. RRP = $5027.14). Overall, costs for all patients in the LRP and RRP groups, respectively, were $606 307.29 and $618 721.57 with a cost saving of $12 414.28 in favour of the LRP arm.
  
  
  CONCLUSIONS
  At our institution, we found that LRP costs are slightly less than those for RRP. Higher operative time and disposable instrument expenses are offset by the shorter hospital stays, fewer blood transfusions and less analgesic requirements for the LRP group. Further financial advantages for LRP will likely be achieved with additional reduction of operating room time and by minimizing disposables.
authors.affiliation: Division of Urology, McMaster University, Hamilton, ON;
authors.forename: Tariq F
authors.initials: TF
authors.lastname: Al-Shaiji
authors.forename: Niki
authors.initials: N
authors.lastname: Kanaroglou
authors.forename: Achilleas
authors.initials: A
authors.lastname: Thom
authors.forename: Connie
authors.initials: C
authors.lastname: Prowse
authors.forename: Vikram
authors.initials: V
authors.lastname: Comondore
authors.forename: William
authors.initials: W
authors.lastname: Orovan
authors.forename: Kevin
authors.initials: K
authors.lastname: Piercey
authors.forename: Paul
authors.initials: P
authors.lastname: Whelan
authors.forename: Leo
authors.initials: L
authors.lastname: Winter
authors.forename: Edward D
authors.initials: ED
authors.lastname: Matsumoto