Assessing the costs and consequences of laparoscopic vs. open methods of groin hernia repair: a systematic review

Abstract

Background: We aimed to provide unbiased estimates of cost-effectiveness by systematically reviewing published cost and cost-effectiveness data derived from studies with rigorous designs that compared laparoscopic with open groin hernia repair.

Methods: Studies reporting costs and outcomes were identified as part of a systematic review of randomized controlled trials comparing laparoscopic with open repair. The quality of the included studies was assessed against a standard checklist. Cost per recurrence avoided and cost per additional day at usual activities were estimated.

Results: Fourteen studies were identified. Laparoscopic repair was less efficient than open mesh repair in terms of avoiding recurrences, avoided but it had a modest cost per additional day back at usual activities. Laparoscopic repair is more likely to be efficient when compared with open nonmesh repair.

Conclusion: The type of open repair with which laparoscopic repair is compared influences its cost-effectiveness. The earlier return to usual activities provided by laparoscopic repair may make it worthwhile in some circumstances.