One-stop routing for surgical interventions: a cost-analysis of endoscopic groin repair

  • Coen van HessenEmail author
  • Marleen Roos
  • Geert Frederix
  • Egbert Jan Verleisdonk
  • Geert Jan Clevers
  • Paul Davids
  • Josephina Burgmans



Single-visit (SV) totally extraperitoneal (TEP) inguinal hernia repair is an efficient service without impairment of safety or complication rate. Data on the economic impact of this approach are rare. The aim of this study was to compare the costs between the SV TEP and the regular TEP in an employed healthy population from a hospital and societal point of view.


Retrospectively collected hospital costs and prospectively collected societal costs were obtained from patients treated between July 2016 and January 2018. Outcome measures consisted of all documented institutional care, productivity loss and medical consumption.


For analysing the hospital costs, a total of 116 SV patients were matched to 116 regular patients. The hospital costs of a mean SV patient were €1148.78 compared to €1242.84 for a regular patient, with a mean difference of €94.06. Prospective analyses of 50 SV patients and 50 regular patients demonstrated higher societal costs for a mean regular patient (€2188.33) compared to a mean SV patient (€1621.44). The mean total cost difference between a SV TEP repair and a regular TEP repair equalled €660.95 corresponding to a 19.3% decrease in costs.


This comprehensive cost-analysis showed that in an employed, healthy population, the SV TEP repair outprices the regular TEP repair, with savings of €660.95 per patient, reflecting a 19.3% decrease in costs. This routing is mainly interesting from a societal point of view as the difference is mainly impacted by a decrease in societal costs.


Inguinal hernia Single visit One-stop shop Cost-analysis TEP 


Compliance with ethical standards


Coen V van Hessen, Marleen M Roos, Geert WJ Frederix, Egbert Jan MM Verleisdonk, Geert Jan Clevers, Paul HP Davids and Josephina PJ Burgmans declare that they have no conflict of interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Ethical standards

Ethical approval was obtained by the Regional Medical Ethics Committee and the hospitals Ethics Board.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Surgery/Hernia ClinicDiakonessenhuis Utrecht/ZeistZeistThe Netherlands
  2. 2.Julius CentreUniversity Medical Centre UtrechtUtrechtThe Netherlands
  3. 3.Department of SurgeryDiakonessenhuis Utrecht/ZeistZeistThe Netherlands

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