Single Incision Laparoscopic Cholecystectomies Cost Comparison

Objective: Cholecystectomy performed using the Single Incision Laparoscopic Surgery (SILS) technique should not cost significantly more or less than standard multiport cholecystectomy. Single access techniques are becoming more common for a multitude of laparoscopic procedures. Criticism has revolved around potential costs associated with increased operative time and use of innovative equipment.

Methods: Retrospective cost data was collected from the accounting records of a single institution. A direct comparison of standard multiport cholecystectomies to SILS cholecystectomies was conducted. Data on the SILS cases that were converted to multiport cholecystectomies was included. Total operating room (OR) cost (actual cost to the hospital for equipment, time, and personnel) and total OR charges (the “list” price, or what the patient was billed, for equipment, time, and personnel) were examined. Total hospital charges (OR charges plus hospital charges accrued in the perioperative period) were also included. Descriptive statistics were used to analyze the data with p-values of statistical significance <0.05.

Results:
Data on 48 standard multiport cholecystectomies, 59 SILS cholecystectomies, and 9 cholecystectomies converted from SILS to multiport was included. All p-values exceeded 0.05.

Total Cost of OR Charges Or Charges Total Hospital Charges
Standard 2069+/- 532 8961 +/- 2332 15412 +/- 7586
SILS 2001 +/- 629 9041 +/- 1489 13986 +/- 4234
Converted 2817 +/- 938 11767 +/- 1678 17555 +/- 4065

Conclusion: There is no significant difference between total OR cost, charges to the patient, and hospital charges when comparing SILS cholecystectomy to standard multiport cholecystectomy. Less equipment was required for a SILS cholecystectomy and the operative times were not significantly different when compared with multiport laparoscopy. Increased costs for SILS cases from occasionally required specialty items were offset by not opening other items typically used during a multiport case. Converted cases were consistently more expensive than either technique alone as these often required additional time and instruments.


Session: Podium Presentation

Program Number: S093

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