Comparison of Costs in Laparoscopic Inguinal Hernia Repairs among Surgeons from a Single Institution

Steven Groene, MD, Tanushree Prasad, MA, Amy Lincourt, PhD, MBA, Brent Matthews, MD, B. Todd Heniford, MD, Vedra Augenstein, MD. Carolinas Medical Center


Laparoscopic inguinal hernia repairs (LIHR) are performed commonly, however, there is no standardized item utilization in place for the procedure.  Our aim was to evaluate and compare cost data amongst surgeons whom perform this procedure using different surgical approaches and supplies.


Review of supply utilization cost data, procedure volume and average case length from 9 surgeons within the Carolinas Healthcare System (CHS) from July 2014 to June 2015 was performed.  Descriptive statistics were used to summarize the data.


The average case volume among the 9 surgeons was 14 cases, with minimum 1 case and maxium 37 cases.  The average OR time among the surgeons was 110 minutes, with a minimum case length of 101 minutes and maximum 131 minutes.  Surgeons E, F and I performed TEP, the others TAP.  The average supply utilization cost of the LIHR was $1100, with costs ranging from $825 to $1381.  Trocars represented 53% of the total supply cost, followed by mesh accounting for 20%, suture/fixation 9% and hemostatics 7%. While all surgeons had their highest percent supply utilization cost in trocars, Surgeon F had the highest percentage at 71%(compared to the group average of 53%).  Surgeon E had a higher percent utilization in suture/fixation compared to the group average(20% vs 9%).  Surgeon D had a higher percent utilization in hemostatics than the group average(33% vs 7%).


Within CHS, there is a difference in case volume, average case length and cost among 9 surgeons who performed LIHR.  The surgeon with the highest average costs had a higher percent utilization cost for suture/fixation, the surgeon with the second highest costs for trocars, and the surgeon with the third highest costs for hemostatic agents than the group average.

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