Cost–Benefit Analysis Comparing Laparoscopic and Open Ventral Hernia Repair

Lobato, R Fernández; Belbel, Juan Carlos Ruiz de Adana; Morales, Francisco Angulo; Septiem, Javier García; Lucas, Francisco Javier; Esteban, Manuel Limones

doi:10.1016/j.cireng.2013.04.011

Cited by 10 publications

(5 citation statements)

References 35 publications

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“…The growing number of laparoscopic procedures in the study is a positive trend for Romania, as it offers patients a less invasive and potentially more effective option for groin hernia repair. Laparoscopic repair has been shown to have lower rates of postoperative pain, shorter hospital stays, faster recovery times, and thus to be less expensive than open-mesh surgery [ 25 , 26 , 27 ]. A 2015 Romanian study found laparoscopic GHRS to have shorter postoperative care periods by 1.8 days [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Groin Hernia Repair during the COVID-19 Pandemic—A Romanian Nationwide Analysis

et al. 2023

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Background and Objectives: Groin hernia repair surgery (GHRS) is among the most common elective interventions. The aim of this three-year nationwide study on GHRS is to provide a thorough analysis of the impact that the COVID-19 pandemic had on the Romanian Health System in regard to elective procedures. Materials and Methods: 46,795 groin hernia cases obtained between 2019 and 2021 from the DRG database using ICD-10 diagnostic codes. The data were collected from all 261 GHRS performing hospitals nationwide, including 227 public hospitals (PbH) and 34 private hospitals (PvH). The 42 variables taken into account were processed using Microsoft Excel 2021, applying Chi square, F-Test Two-Sample for variances, and Two Sample t-Test. The significance threshold considered was p < 0.001. Results: Of the grand total of cases, 96.2% were inguinal hernias, 86.8% were performed on men, 15.2% were laparoscopic procedures, and 6.88% were in PvH. Overall, due to the pandemic, the total number of GHRS decreased with 44.45% in 2020 and with 29.72% in 2021 compared to pre-pandemic year 2019. April 2020 shows the steepest decrease in GHRS (91 procedures nationwide). In the private sector, there was an opposite trend with increases in the number of cases by 12.21% and a 70.22% in both pandemic years. The mean admission period (MAP) for all procedures was 5.5 days. There was a significant difference between PbH and PvH (5.75 vs. 2.8 days, p < 0.0001). During the pandemic, the MAP in PbH decreased (6.02 in 2019, 5.82 in 2020 and 5.3 in 2021), remaining stable for PvH (2.9 days in 2019, 2.85 days in 2020 and 2.74 days in 2021). Conclusion: The COVID-19 pandemic significantly reduced the overall number of GHRS performed in Romania in 2020 and 2021, compared to 2019. However, the private sector thrived with an actual increase in the number of cases. There was a significant lower MAP in the PvH compared to PbH throughout the three-year period.

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Section: Discussionmentioning

confidence: 99%

Groin Hernia Repair during the COVID-19 Pandemic—A Romanian Nationwide Analysis

et al. 2023

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“…Fernandez et al showed that the cost of disposable surgical supplies was higher with laparoscopic repair, but since this approach is associated with a reduced postoperative complications and hospitalization, so the overall total costs were lower than open mesh repair and the procedure was considered as a cost-effective. 30 The INCH trial by Poelman et al reported that laparoscopic repair resulted in rapid recovery and early return to work and hence is a more cost-effective. 31 Lastly, Kingsnorth et al recommended that large (more than10 cm) and complex incisional hernia especially those with loss of domain are better to repair by open mesh technique.…”

Section: Discussionmentioning

confidence: 99%

Incisional hernia: conventional open mesh versus laparoscopic repair; a randomized controlled study

Alsubaiee

2020

Int Surg J

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Background: Incisional hernia is a common complication after laparotomy. Up to now, there is no consensus on the ideal surgical approach of such hernia. The aim of the present study was to compare the surgical outcomes, feasibility and cost effectiveness of the open mesh repair and laparoscopic repair of incisional hernia.Methods: A randomized controlled study conducted between August 2015 and September 2019 in which 64 patients with incisional hernias were randomly selected for either open mesh repair (36 patients) or laparoscopic repair (28 patients).Results: Patients in both groups were similar in their characteristics. The mean operative time was significantly longer in laparoscopic repair than in open mesh repair (128.6±15 minutes versus 89.8±82 minutes, p<0.05). The peri-operative complications and intra-operative blood loss were comparable in the two groups. The use of the drain was significantly higher in open group than in laparoscopic repair group (44.4% versus 10.7%). The overall rate of postoperative complications was similar in both groups, (25% for each group). The rate of wound infection and the length of hospitalization were significantly less in laparoscopic repair group. The results of postoperative pain score, cosmetic outcomes and recurrence rate showed no significant differences between the two groups but patient's satisfaction was significantly higher in laparoscopic repair. p>0.05.Conclusion: Both laparoscopic and conventional open mesh repair of incisional hernia are equivalent and feasible and safe technique. Laparoscopic repair was superior to open mesh repair in term of surgical site infection, hospital stay and patient’s satisfaction only.

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“…La patología herniaria representa un área de especial interés para los cirujanos generales, y dentro de este grupo, la corrección de la hernia ventral es un tópico que se busca dominar. La incidencia de hernia ventral primaria se mantiene estática, mientras que la de las hernias incisionales aumenta progresivamente, debido al gran número de laparotomías realizadas durante el siglo XX 6 ; con una tasa reportada de 3-20 % en Estados Unidos 7 .…”

Section: Discussionunclassified

Técnica extraperitoneal comparada con IPOM plus: Análisis de costos evitados para optimizar el manejo de la hernia ventral por laparoscopia

Ruiz

Barrios²,

Vega

et al. 2020

Rev Colomb Cir

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Introducción. Analizamos los costos en el reparo extraperitoneal de la hernia ventral por laparoscopia, desde la perspectiva del sistema general de salud de Colombia, con el fin de mostrar los beneficios de dicho abordaje y su impacto económico, al compararlo con la técnica más implementada, el IPOM plus. Métodos. Se realizó un análisis económico de costo-beneficio, desde la perspectiva del Sistema General de Seguridad Social en Salud (SGSSS) de Colombia, comparando los costos del reparo de hernia ventral con la técnica extraperitoneal, TAPP o TEP, versus el IPOM plus. Se tomaron como costos de referencia lo establecido en el manual tarifario de Instituto de Seguros Sociales. Los datos fueron analizados con Stata V.15 Resultados. Se recolectó y analizo información de 109 procedimientos; 59 del grupo extraperitoneal TAPP/TEP y 50 del grupo IPOM plus, realizados durante los años 2015 a 2018, por el grupo de pared abdominal de Clínica Colsanitas, identificando un ahorro del 69,8 % o resultados de costo-beneficio a favor del grupo extraperitoneal. Discusión. El abordaje extraperitoneal en el reparo de hernia ventral se consideró una estrategia de alto costo-beneficio para el sistema de salud, validado por la experiencia del grupo de pared abdominal de Clínica Colsanitas, al compararla con el abordaje habitual. Teniendo en cuenta que los insumos utilizados para la disección no cambian, la prótesis utilizada para cada una de las técnicas representa un costo importante a considerar, tanto para el sistema como para las instituciones de salud

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Cost–Benefit Analysis Comparing Laparoscopic and Open Ventral Hernia Repair

Cited by 10 publications

References 35 publications

Groin Hernia Repair during the COVID-19 Pandemic—A Romanian Nationwide Analysis

Groin Hernia Repair during the COVID-19 Pandemic—A Romanian Nationwide Analysis

Incisional hernia: conventional open mesh versus laparoscopic repair; a randomized controlled study

Técnica extraperitoneal comparada con IPOM plus: Análisis de costos evitados para optimizar el manejo de la hernia ventral por laparoscopia

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