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Meta-Analysis
. 2018 Jan-Feb;39(1):24-34.
doi: 10.11138/gchir/2018.39.1.024.

Higher cost of single incision laparoscopic cholecystectomy due to longer operating time. A study of opportunity cost based on meta-analysis

F Fuertes-Guirò, M Girabent-Farrés
Meta-Analysis

Higher cost of single incision laparoscopic cholecystectomy due to longer operating time. A study of opportunity cost based on meta-analysis

F Fuertes-Guirò et al. G Chir. 2018 Jan-Feb.

Abstract

Background: We aimed to calculate the opportunity cost of the operating time to demonstrate that single incision laparoscopic cholecystectomy (SILC) is more expensive than classic laparoscopic cholecystectomy (CLC).

Methods: We identified studies comparing use of both techniques during the period 2008-2016, and to calculate the opportunity cost, we performed another search in the same period of time with an economic evaluation of classic laparoscopy. We performed a meta-analysis of the items selected in the first review considering the cost of surgery and surgical time, and we analyzed their differences. We subsequently calculated the opportunity cost of these time differences based on the design of a cost/time variable using the data from the second literature review.

Results: Twenty-seven articles were selected from the first review: 26 for operating time (3.138 patients) and 3 for the cost of surgery (831 patients), and 3 articles from the second review. Both echniques have similar operating costs. Single incision laparoscopy surgery takes longer (16.90min) to perform (p <0.00001) and this difference represents an opportunity cost of 755.97 € (cost/time unit factor of 44.73 €/min).

Conclusions: SILC costs the same as CLC, but the surgery takes longer to perform, and this difference involves an opportunity cost that increases the total cost of SILC. The value of the opportunity cost of the operating time can vary the total cost of a surgical technique and it should be included in the economic evaluation to support the decision to adopt a new surgical technique.

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Conflict of interest statement

Conflict of interests

Fernando Fuertes-Guiró declares that he has no conflict of interest.

Montserrat Girabent-Farrés declares that she has no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the selection process of articles for inclusion in the meta-analysis.
Figure 2
Figure 2
Flow chart of the selection of articles for inclusion in the opportunity cost estimation.
Figure 3
Figure 3
Funnel plot of cost of surgery (€).
Figure 4
Figure 4
Forest plot of cost of surgery (€).
Figure 5
Figure 5
Funnel plot of operating time (min).
Figure 6
Figure 6
Forest plot of operating time (min).
See this image and copyright information in PMC

References

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