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

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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.

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Authors and Affiliations

  1. Department of Surgery, The University of Hawaii John A. Burns School of Medicine, Honolulu, HI, 96813, USA

    Dean J. Mikami & Kenric M. Murayama

  2. Department of Surgery, Montefiore Medical Center, Bronx, NY, USA

    W. Scott Melvin

  3. University of Hawaii John A. Burn School of Medicine, 1356 Lusitana Street, 6th Floor, Honolulu, HI, USA

    Michael J. Murayama

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  1. Dean J. Mikami
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  2. W. Scott Melvin
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  3. Michael J. Murayama
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  4. Kenric M. Murayama
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Disclosures

Dean Mikami is a consultant for Medtronic, W.L. Gore and BD. W. Scott Melvin is a consultant for Stryker. Kenric Murayama and Michael Murayama have no conflict of interest.

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Mikami, D.J., Melvin, W.S., Murayama, M.J. et al. Impact of minimally invasive surgery on healthcare utilization, cost, and workplace absenteeism in patients with Incisional/Ventral Hernia (IVH). Surg Endosc 31, 4412–4418 (2017). https://doi.org/10.1007/s00464-017-5488-y

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  • DOI: https://doi.org/10.1007/s00464-017-5488-y

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