Economic impact of laparoscopic versus open abdominal rectopexy

Abstract
Background: The introduction of new laparoscopic techniques has important cost implications. The aim of this study was to compare the cost effectiveness of laparoscopic rectopexy with that of open abdominal rectopexy for full‐thickness rectal prolapse. Methods: A cost effectiveness study was conducted alongside a randomized trial of laparoscopic versus open abdominal rectopexy. Results: The efficacy trial demonstrated significant subjective and objective differences in favour of the laparoscopic technique. The mean operating time was 51 min longer for laparoscopic rectopexy than for the open procedure. Laparoscopic disposables incurred a mean cost of £291 per patient. The mean duration of hospital stay was significantly shorter for the laparoscopic group (P = 0·001). Laparoscopic rectopexy was associated with an overall mean cost saving of £357 (95 per cent confidence interval £164 to £592; P = 0·042) per patient. Conclusion: Laparoscopic rectopexy is associated with superior clinical outcomes and is cheaper than the open approach. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.