Laparoscopic and abdominal hysterectomy: a cost comparison

Tsaltas, Jim; Magnus, Anne; Mamers, Pam; Lawrence, Anthony; Lolatgis, Nicholas; Healy, David

doi:10.5694/j.1326-5377.1997.tb140078.x

Cited by 19 publications

(13 citation statements)

References 15 publications

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“…A large difference of 3.55 days found in our data (table 1) was the main driver of cost savings. Studies from the USA, 21 Australia, 22 France 23 and the UK 24 found costs of TAH and TLH to be similar or not significantly different and consistently reported a significantly shorter hospital stay for TLH. A recent cost comparison of different treatment approaches for endometrial cancer found TLH to be the least expensive alternative with costs ranging from US$6581-US$10 128 compared to US$7009-US$12 847 for TAH, depending on the range of costs included in the analysis.…”

Section: Discussionmentioning

confidence: 97%

The cost-effectiveness of total laparoscopic hysterectomy compared to total abdominal hysterectomy for the treatment of early stage endometrial cancer

et al. 2013

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ObjectiveTo summarise how costs and health benefits will change with the adoption of total laparoscopic hysterectomy compared to total abdominal hysterectomy for the treatment of early stage endometrial cancer.DesignCost-effectiveness modelling using the information from a randomised controlled trial.ParticipantsTwo hypothetical modelled cohorts of 1000 individuals undergoing total laparoscopic hysterectomy and total abdominal hysterectomy.Outcome measuresSurgery costs; hospital bed days used; total healthcare costs; quality-adjusted life years; and net monetary benefits.ResultsFor 1000 individuals receiving total laparoscopic hysterectomy surgery, the costs were $509 575 higher, 3548 hospital fewer bed days were used and total health services costs were reduced by $3 746 221. There were 39.13 more quality-adjusted life years for a 5 year period following surgery.ConclusionsThe adoption of total laparoscopic hysterectomy is almost certainly a good decision for health services policy makers. There is 100% probability that it will be cost saving to health services, a 86.8% probability that it will increase health benefits and a 99.5% chance that it returns net monetary benefits greater than zero.

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Section: Discussionmentioning

confidence: 97%

The cost-effectiveness of total laparoscopic hysterectomy compared to total abdominal hysterectomy for the treatment of early stage endometrial cancer

et al. 2013

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“…In a study by Tsaltas J et al, fibroid was the most common indication in TAH group as in this study but in NDVH group DUB was more common indication in Shanthini and all other studies. 18,22 In the present study, volume reductive methods were used in 15 cases. Mean blood loss LAVH was 150 ml but still it was less than mean blood loss in TAH (201 ml.)…”

Section: Discussionmentioning

confidence: 99%

Comparative study of intra and post-operative complications between total abdominal hysterectomy and laparoscopic assisted vaginal hysterectomy

Priya

Allirathnam

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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Background: Vaginal hysterectomy is preferable due to faster recovery, decreased morbidity and absence of an abdominal incision. The aim was to compare the risks and complications of laparoscopy assisted vaginal hysterectomy and total abdominal hysterectomy in terms of intra-operative and post-operative complications.Methods: A retrospective observational study was conducted in the Gynaecology ward at Vinakaya Mission’s Kirupananda Variyar Medical College and Hospitals, Salem, Tamil Nadu, India. The data for the past 1-year record was taken for analysis. A total of 80 subjects were included in the study and were divided into two groups with 40 patients under TAH (total abdominal hysterectomy) group and 40 under LAVH (Laproscopic assisted vaginal hysterectomy) group. The primary outcome of the present analysis was incidence of perioperative complications like blood loss and the secondary outcomes were operating time, blood loss, urinary tract injury, rate of conversion to laparotomy, postoperative pain, and length of postoperative stay.Results: The mean intra-operative blood loss was measured among both the groups and it was found to be very high among TAH group (201 ml) compared to LAVH group (149.8 ml) and the difference was found to be statistically significant (p <0.05). Similarly, the duration of operative procedure was found to be less in LAVH group (57.9 mins) compared to TAH group (72.6 mins) and the difference was found to be statistically significant (p <0.05). Post-operative wound infection (14 vs 0) was found to be more among the patients in TAH group than that of the LAVH group and the difference was found to be statistically significant (p <0.05).Conclusions: LAVH is a safe and effective surgical treatment for benign gynaecological diseases and should be offered whenever possible, taking into account the low rate of complications and cost-effectiveness.

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“…This may provide financial/ economic benefits to the hospital because it allows higher patient occupancy per bed and advantages the patient by allowing resumption of daily activities earlier than conventional surgery. Davison et al (1993) and Tsaltas et al (1997) family disruptions; and an unnecessary financial expenditure on the health care system.…”

Section: (A) Cost Savings To Hospital and Patientmentioning

confidence: 97%

Patient education and the prevention of incisional hernia

Newman²

2001

Contemporary Nurse

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Laparoscopic or 'key hole' surgery has become an acceptable technique for abdominal surgery. This technique is utilised by surgeons who work in tertiary hospitals as well as those in private, day only, surgical facilities. Despite the increasing use of this technique in Australia, a paucity of information is available in the journals about the real or potential complications the patient may suffer following this method of surgery. The first author of this paper who works in the operating room practice domain, observed over three years a number of patients readmitted for repair of incisional hernia following abdominal laparoscopic surgery. A review of the international literature and dialogue with operating nurses from institutions in Sydney and Hong Kong confirmed there was enough evidence to warrant examining the complication of incisional hernia as a clinical problem. It would appear from the literature that incidence rate is unknown in Australia. Several reasons may account for this. First, it appears that few surgeons are documenting patient outcomes of laparoscopic surgery, not withstanding the proliferation of its use in the last five years. The second possible reason is the paucity of published information available in the journals, perhaps because the technique is still viewed as relatively new and experimental. This paper outlines a brief history of laparoscopic surgery and some responsibilities nurses have in relation to patient education and the prevention of post-operative complications.

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Laparoscopic and abdominal hysterectomy: a cost comparison

Cited by 19 publications

References 15 publications

The cost-effectiveness of total laparoscopic hysterectomy compared to total abdominal hysterectomy for the treatment of early stage endometrial cancer

The cost-effectiveness of total laparoscopic hysterectomy compared to total abdominal hysterectomy for the treatment of early stage endometrial cancer

Comparative study of intra and post-operative complications between total abdominal hysterectomy and laparoscopic assisted vaginal hysterectomy

Patient education and the prevention of incisional hernia

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