BACKGROUND: Laparoscopic inguinal hernia surgery is increasingly seen as the superior technique in hernia repair. Compared to open-mesh hernia repair, laparoscopic approaches are often reported to be more cost-effective but incur higher costs for the provider. The objective of this study was to analyze the effect of transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) repair of nonincarcerated inguinal hernias in men on hospital costs and length of stay (LoS). METHODS: We used routine administrative, highly standardized, patient-level cost data from 15 German hospitals participating in the national cost data study. We compared TEP, TAPP, and open-mesh repair. We conducted propensity score matching to account for baseline differences between treatment groups and subsequently estimated the treatment effect on costs and LoS. RESULTS: Total costs for both TEP and TAPP surgery were significantly lower than those for open-mesh repair (p < 0.0001 and p < 0.05, respectively). TEP repair also had a slight but nonsignificant advantage in total costs compared to TAPP repair, while TAPP surgery was associated with a significantly shorter LoS than TEP (p < 0.001). CONCLUSION: Results suggest that laparoscopic approaches in hernia repair are not necessarily associated with higher hospital resource consumption than open-mesh repair.
BACKGROUND: Laparoscopic inguinal hernia surgery is increasingly seen as the superior technique in hernia repair. Compared to open-mesh hernia repair, laparoscopic approaches are often reported to be more cost-effective but incur higher costs for the provider. The objective of this study was to analyze the effect of transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) repair of nonincarcerated inguinal hernias in men on hospital costs and length of stay (LoS). METHODS: We used routine administrative, highly standardized, patient-level cost data from 15 German hospitals participating in the national cost data study. We compared TEP, TAPP, and open-mesh repair. We conducted propensity score matching to account for baseline differences between treatment groups and subsequently estimated the treatment effect on costs and LoS. RESULTS: Total costs for both TEP and TAPP surgery were significantly lower than those for open-mesh repair (p < 0.0001 and p < 0.05, respectively). TEP repair also had a slight but nonsignificant advantage in total costs compared to TAPP repair, while TAPP surgery was associated with a significantly shorter LoS than TEP (p < 0.001). CONCLUSION: Results suggest that laparoscopic approaches in hernia repair are not necessarily associated with higher hospital resource consumption than open-mesh repair.
Authors: R Bittner; M E Arregui; T Bisgaard; M Dudai; G S Ferzli; R J Fitzgibbons; R H Fortelny; U Klinge; F Kockerling; E Kuhry; J Kukleta; D Lomanto; M C Misra; A Montgomery; S Morales-Conde; W Reinpold; J Rosenberg; S Sauerland; C Schug-Pass; K Singh; M Timoney; D Weyhe; P Chowbey Journal: Surg Endosc Date: 2011-07-13 Impact factor: 4.584
Authors: A Eklund; C Rudberg; S Smedberg; L K Enander; C E Leijonmarck; J Osterberg; A Montgomery Journal: Br J Surg Date: 2006-09 Impact factor: 6.939
Authors: Leigh Neumayer; Anita Giobbie-Hurder; Olga Jonasson; Robert Fitzgibbons; Dorothy Dunlop; James Gibbs; Domenic Reda; William Henderson Journal: N Engl J Med Date: 2004-04-25 Impact factor: 91.245
Authors: M P Simons; T Aufenacker; M Bay-Nielsen; J L Bouillot; G Campanelli; J Conze; D de Lange; R Fortelny; T Heikkinen; A Kingsnorth; J Kukleta; S Morales-Conde; P Nordin; V Schumpelick; S Smedberg; M Smietanski; G Weber; M Miserez Journal: Hernia Date: 2009-07-28 Impact factor: 4.739
Authors: F Köckerling; R Bittner; D A Jacob; L Seidelmann; T Keller; D Adolf; B Kraft; A Kuthe Journal: Surg Endosc Date: 2015-03-25 Impact factor: 4.584