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Surgical Endoscopy

, Volume 25, Issue 4, pp 1127–1135 | Cite as

Safety, efficacy, and cost-effectiveness of common laparoscopic procedures

  • Manish M. Tiwari
  • Jason F. Reynoso
  • Robin High
  • Albert W. Tsang
  • Dmitry Oleynikov
Article

Abstract

Background

Laparoscopic surgery has been shown to offer superior surgical outcomes for most abdominal surgical procedures. However, there is hardly any evidence on surgical outcomes with patient risk stratification. This study aimed to compare outcomes of common laparoscopic and open surgical procedures for varying illness severity.

Methods

A retrospective analysis of surgical outcomes for six commonly performed surgical procedures including cholecystectomy, appendectomy, reflux surgery, gastric bypass surgery, ventral hernia repair, and colectomy was performed using the University HealthSystem Consortium (UHC) Clinical Database/Resource Manager (CDB/RM). The 3-year discharge data for the six commonly performed laparoscopic surgical procedures were analyzed for outcome measures including observed mortality, overall patient morbidity, intensive care unit (ICU) admissions, 30-day readmissions, length of hospital stay, and hospital costs.

Results

In this study, 208,314 patients underwent one of six common surgical procedures by either the open or the laparoscopic approach. Overall, the laparoscopic approach showed significantly lower mortality, reduced morbidity, fewer ICU admissions and 30-day readmissions, shorter hospital stay, and significantly reduced hospital costs for all the procedures. At stratification by illness severity, the laparoscopic group showed better or comparable surgical outcomes across all the illness severity groups. However, the observed mortality was comparable for the minor and moderate severity patients between laparoscopic and open surgery for most procedures. The 30-day readmission rate for major/extreme severity patients was comparable between the two groups for most surgical procedures.

Conclusions

This study demonstrated the superiority of laparoscopy over conventional open surgery across all illness severity risk groups for common surgical procedures. The results in general show that laparoscopic surgery is safe, efficacious, and cost-effective compared with open surgery and suggest that laparoscopic surgery should be the procedure of choice for all common surgical procedures, regardless of illness severity.

Keywords

Appendectomy Cholecystectomy Colectomy Gastric bypass Laparoscopic surgery Open surgery Outcomes Reflux surgery Ventral hernia 

Notes

Disclosures

Authors Manish M. Tiwari, Jason F. Reynoso, Robin High, Albert W. Tsang, and Dmitry Oleynikov have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Manish M. Tiwari
    • 1
  • Jason F. Reynoso
    • 1
  • Robin High
    • 2
  • Albert W. Tsang
    • 1
  • Dmitry Oleynikov
    • 1
  1. 1.Department of SurgeryUniversity of Nebraska Medical CenterOmahaUSA
  2. 2.Department of BiostatisticsUniversity of Nebraska Medical CenterOmahaUSA

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