Hospital costs associated with laparoscopic and open inguinal herniorrhaphy.
OBJECTIVE
The purpose of this study was to compare the total hospital costs associated with elective laparoscopic and open inguinal herniorrhaphy.


METHODS
A prospectively maintained database was used to identify patients who underwent elective inguinal herniorrhaphy from April 2009 to March 2011. A retrospective review of electronic patient records was performed along with a standardized case-costing analysis using data from the Ontario Case Costing Initiative. The main outcomes were operating room (OR) and total hospital costs.


RESULTS
Two hundred eleven patients underwent elective unilateral inguinal herniorrhaphy (117 open and 94 laparoscopic), and 33 patients underwent elective bilateral inguinal herniorrhaphy (9 open and 24 laparoscopic). OR and total hospital costs for open unilateral inguinal hernia repair were significantly lower than for the laparoscopic approach (median total cost, $3207.15 vs $3723.66; P < .001). OR and total hospital costs for repair of elective bilateral inguinal hernias were similar between the open and laparoscopic approaches (median total cost, $4574.02 vs $4662.89; P = .827).


CONCLUSIONS
In the setting of a Canadian academic hospital, when considering the repair of an elective unilateral inguinal hernia, the OR and total hospital costs of open surgery were significantly lower than for the laparoscopic techniques. There was no statistical difference between OR and total hospital costs when comparing open surgery and laparoscopic techniques for the repair of bilateral inguinal hernias. Given the perioperative benefits of laparoscopy, further studies incorporating hernia-specific outcomes are necessary to determine the cost-effectiveness of each approach and to define the optimal treatment strategy.
Universidade do Oeste do Parana, Cascavel, Brazil.
Fernando
F
Spencer Netto
Division of General Surgery, University Health Network, Toronto, Ontario, Canada.
Fayez
F
Quereshy
Universidade Regional de Blumenau, Blumenau, Brazil.
Bruna G
BG
Camilotti
Division of General Surgery, University Health Network, Toronto, Ontario, Canada.
Kristen
K
Pitzul
Division of General Surgery, University Health Network, Toronto, Ontario, Canada.
Josephine
J
Kwong
Division of General Surgery, University Health Network, Toronto, Ontario, Canada.
Timothy
T
Jackson
Division of General Surgery, University Health Network, Toronto, Ontario, Canada.
Todd
T
Penner
Division of General Surgery, University Health Network, Toronto, Ontario, Canada.
Allan
A
Okrainec
D000368:Aged; D003365:Costs and Cost Analysis; D017558:Elective Surgical Procedures / Q000191:economics*; D005260:Female; D006552:Hernia, Inguinal / Q000191:economics / Q000601:surgery*; D059685:Herniorrhaphy / Q000191:economics* / Q000379:methods; D017721:Hospital Costs; D006801:Humans; D010535:Laparoscopy / Q000191:economics* / Q000379:methods; D007813:Laparotomy / Q000191:economics* / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
Hospital costs; Inguinal herniorrhaphy; Laparoscopic inguinal herniorrhaphy; Open inguinal herniorrhaphy