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Long-term cost-minimization analysis comparing laparoscopic with open (Lichtenstein) inguinal hernia repair
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.ORCID iD: 0000-0003-3691-8326
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2010 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 97, no 5, 765-771 p.Article in journal (Refereed) Published
Abstract [en]


Laparoscopic surgery has emerged as a new treatment modality for inguinal hernia repair. The aim of the present study was to analyse its long-term costs in relation to those of open repair.


A randomized multicentre study comparing totally extraperitoneal laparoscopic repair (TEP) with open repair by the Lichtenstein procedure was performed on men with a primary inguinal hernia. Long-term data on recurrences and complications up to 5 years after operation were collected. Taking treatment costs into consideration, a cost-minimization analysis was conducted.


A total of 1370 patients had an inguinal hernia repair, 665 in the TEP and 705 in the Lichtenstein group. The total hospital cost for the index operation was €710·6 higher for TEP repair (P < 0·001). Including costs associated with recurrences and complications, this difference increased to €795·1 (P < 0·001). Taking community costs into account, the difference decreased by €503·1 to €292·0 (P = 0·024).


This cost-minimization analysis, including complications, reoperations and community costs during follow-up of 5 years, showed that laparoscopic inguinal hernia repair had a small but significant increase in overall costs compared with open repair.

Place, publisher, year, edition, pages
2010. Vol. 97, no 5, 765-771 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-136583DOI: 10.1002/bjs.6945ISI: 000276947900022OAI: oai:DiVA.org:uu-136583DiVA: diva2:377633
Available from: 2010-12-14 Created: 2010-12-13 Last updated: 2013-07-24Bibliographically approved

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Rosenblad, Andreas
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Centre for Clinical Research, County of Västmanland
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