Skip to main content
Top
Published in: Surgical Endoscopy 11/2017

01-11-2017

Impact of minimally invasive surgery on healthcare utilization, cost, and workplace absenteeism in patients with Incisional/Ventral Hernia (IVH)

Authors: Dean J. Mikami, W. Scott Melvin, Michael J. Murayama, Kenric M. Murayama

Published in: Surgical Endoscopy | Issue 11/2017

Login to get access

Abstract

Background

Incisional hernia repair is one of the most common general surgery operations being performed today. With the advancement of laparoscopy since the 1990s, we have seen vast improvements in faster return to normal activity, shorter hospital stays and less post-operative narcotic use, to name a few.

Objective

The key aims of this review were to measure the impact of minimally invasive surgery versus open surgery on health care utilization, cost, and work place absenteeism in the patients undergoing inpatient incisional/ventral hernia (IVH) repair.

Methods

We analyzed data from the Truven Health Analytics MarketScan® Commercial Claims and Encounters Database. Total of 2557 patients were included in the analysis.

Results

Of the patient that underwent IVH surgery, 24.5% (n = 626) were done utilizing minimally invasive surgical (MIS) techniques and 75.5% (n = 1931) were done open. Ninety-day post-surgery outcomes were significantly lower in the MIS group compared to the open group for total payment ($19,288.97 vs. $21,708.12), inpatient length of stay (3.12 vs. 4.24 days), number of outpatient visit (5.48 vs. 7.35), and estimated days off (11.3 vs. 14.64), respectively. At 365 days post-surgery, the total payment ($27,497.96 vs. $30,157.29), inpatient length of stay (3.70 vs. 5.04 days), outpatient visits (19.75 vs. 23.42), and estimated days off (35.71 vs. 41.58) were significantly lower for MIS group versus the open group, respectively.

Conclusion

When surgical repair of IVH is performed, there is a clear advantage in the MIS approach versus the open approach in regard to cost, length of stay, number of outpatient visits, and estimated days off.
Literature
1.
go back to reference Wechter ME, Pearlman MD, Hartmann KE (2005) Reclosure of the disrupted laparotomy wound: a systematic review. Obstet Gynecol 106(2):376–383CrossRefPubMed Wechter ME, Pearlman MD, Hartmann KE (2005) Reclosure of the disrupted laparotomy wound: a systematic review. Obstet Gynecol 106(2):376–383CrossRefPubMed
2.
go back to reference Fink C, Baumann P, Wente MN, Knebel P, Bruckner T, Ulrich A, Werner J, Buchler MW, Diener MK (2014) Incisional hernia rate 3 years after midline laparotomy. Br J Surg 101(2):51–54CrossRefPubMed Fink C, Baumann P, Wente MN, Knebel P, Bruckner T, Ulrich A, Werner J, Buchler MW, Diener MK (2014) Incisional hernia rate 3 years after midline laparotomy. Br J Surg 101(2):51–54CrossRefPubMed
3.
go back to reference Poulose BK, Shelton J, Phillips S, Moore D, Nealon W, Penson D, Beck W, Holzman MD (2012) Epidemiology and cost of ventral hernia repair: making the case for hernia research. Hernia 16:179–183CrossRefPubMed Poulose BK, Shelton J, Phillips S, Moore D, Nealon W, Penson D, Beck W, Holzman MD (2012) Epidemiology and cost of ventral hernia repair: making the case for hernia research. Hernia 16:179–183CrossRefPubMed
4.
go back to reference LeBlanc KA, Booth WV (1993) Laparoscopic repair of incisional abdominal hernias using expanded polytetrafluoroethylene: preliminary findings. Surg Laparosc Endosc 3:39–41PubMed LeBlanc KA, Booth WV (1993) Laparoscopic repair of incisional abdominal hernias using expanded polytetrafluoroethylene: preliminary findings. Surg Laparosc Endosc 3:39–41PubMed
5.
go back to reference Holman MD, Purut CM, Reintgen S, Eubanks S, Pappas TN (1997) Laparoscopic ventral and incisional hernioplasty. Surg Endosc 11:32–35CrossRef Holman MD, Purut CM, Reintgen S, Eubanks S, Pappas TN (1997) Laparoscopic ventral and incisional hernioplasty. Surg Endosc 11:32–35CrossRef
6.
go back to reference Kaoutzanis C, Leichtle SW, Mouawad NJ, Welch KB, Lampman RM, Cleary RK (2013) Postoperative surgical site infections after ventral/incisional hernia repair: a comparison of open and laparoscopic outcomes. Surg Endosc. doi:10.1007/s00464-012-2743-0 PubMed Kaoutzanis C, Leichtle SW, Mouawad NJ, Welch KB, Lampman RM, Cleary RK (2013) Postoperative surgical site infections after ventral/incisional hernia repair: a comparison of open and laparoscopic outcomes. Surg Endosc. doi:10.​1007/​s00464-012-2743-0 PubMed
7.
go back to reference Goodney PP, Birkmeyer CM, Birkmeyer JD (2002) Short-term outcomes of laparoscopic and open ventral hernia repair. Arch Surg 137:1161–1165CrossRefPubMed Goodney PP, Birkmeyer CM, Birkmeyer JD (2002) Short-term outcomes of laparoscopic and open ventral hernia repair. Arch Surg 137:1161–1165CrossRefPubMed
8.
go back to reference Sajid MS, Bokhari SA, Mallick AS, Cheek E, Baig MK (2009) Laparoscopic versus open repair of incisional/ventral hernia: a meta-analysis. Am J Surg 197:64–72CrossRefPubMed Sajid MS, Bokhari SA, Mallick AS, Cheek E, Baig MK (2009) Laparoscopic versus open repair of incisional/ventral hernia: a meta-analysis. Am J Surg 197:64–72CrossRefPubMed
9.
go back to reference Mason RJ, Moazzez A, Sohn HJ, Berne TV, Katkhouda N (2011) Laparoscopic versus open anterior abdominal wall hernia repair: 30-day morbidity and mortality using the ACS-NSQIP database. Ann Surg 254:641–652CrossRefPubMed Mason RJ, Moazzez A, Sohn HJ, Berne TV, Katkhouda N (2011) Laparoscopic versus open anterior abdominal wall hernia repair: 30-day morbidity and mortality using the ACS-NSQIP database. Ann Surg 254:641–652CrossRefPubMed
10.
11.
go back to reference Krpata DM, Schmotzer BJ, Flocke S, Jin J, Blatnik JA, Ermlich B, Novitsky YW, Rosen MJ (2012) Design and initial implementation of HerQLes: a hernia-related quality-of-life survey to assess abdominal wall function. J Am Coll Surg 215:635–642CrossRefPubMed Krpata DM, Schmotzer BJ, Flocke S, Jin J, Blatnik JA, Ermlich B, Novitsky YW, Rosen MJ (2012) Design and initial implementation of HerQLes: a hernia-related quality-of-life survey to assess abdominal wall function. J Am Coll Surg 215:635–642CrossRefPubMed
12.
go back to reference Kouhia ST, Heiskanen JT, Huttunen R, Ahtola HI, Kiviniemi VV, Hakala T (2010) Long-term follow-up of a randomized clinical trial of open versus laparoscopic appendectomy. Br J Surg 97(9):1395–1400CrossRefPubMed Kouhia ST, Heiskanen JT, Huttunen R, Ahtola HI, Kiviniemi VV, Hakala T (2010) Long-term follow-up of a randomized clinical trial of open versus laparoscopic appendectomy. Br J Surg 97(9):1395–1400CrossRefPubMed
13.
go back to reference Nguyen NT, Ho HS, Palmer LS et al (2000) A comparison study of laparoscopic versus open gastric bypass for morbid obesity. J Am Coll Surg 191:149–155CrossRefPubMed Nguyen NT, Ho HS, Palmer LS et al (2000) A comparison study of laparoscopic versus open gastric bypass for morbid obesity. J Am Coll Surg 191:149–155CrossRefPubMed
14.
go back to reference Qiu S, Doyon LM, Divino CM (2014) The safety of laparoscopic versus open ventral hernia repair in 23,327 morbidly obese patients. J Surg Res 186(2):538–538CrossRef Qiu S, Doyon LM, Divino CM (2014) The safety of laparoscopic versus open ventral hernia repair in 23,327 morbidly obese patients. J Surg Res 186(2):538–538CrossRef
15.
go back to reference Holzer A, Jirecek ST, Illievich UM, Huber J, Wenzl RJ (2006) Laparoscopic versus open myomectomy: a double-blind study to evaluate postoperative pain. Anesth Analg 102(5):1480–1484CrossRefPubMed Holzer A, Jirecek ST, Illievich UM, Huber J, Wenzl RJ (2006) Laparoscopic versus open myomectomy: a double-blind study to evaluate postoperative pain. Anesth Analg 102(5):1480–1484CrossRefPubMed
16.
go back to reference Neumayer L, Giobbie-Hurder A, Jonasson O, Fitzgibbons R, Dunlop D, Gibbs J, Reda D, Henderson W (2004) Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med 350(18):1819–1827CrossRefPubMed Neumayer L, Giobbie-Hurder A, Jonasson O, Fitzgibbons R, Dunlop D, Gibbs J, Reda D, Henderson W (2004) Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med 350(18):1819–1827CrossRefPubMed
17.
go back to reference Funk LM, Perry KA, Narula VK, Mikami DJ, Melvin WS (2013) Current national practice patterns for inpatient management of ventral abdominal wall hernia in the United States. Surg Endosc 27(11):4112CrossRef Funk LM, Perry KA, Narula VK, Mikami DJ, Melvin WS (2013) Current national practice patterns for inpatient management of ventral abdominal wall hernia in the United States. Surg Endosc 27(11):4112CrossRef
Metadata
Title
Impact of minimally invasive surgery on healthcare utilization, cost, and workplace absenteeism in patients with Incisional/Ventral Hernia (IVH)
Authors
Dean J. Mikami
W. Scott Melvin
Michael J. Murayama
Kenric M. Murayama
Publication date
01-11-2017
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 11/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-017-5488-y

Other articles of this Issue 11/2017

Surgical Endoscopy 11/2017 Go to the issue