You have full access to this open access article. A direct comparison of the cost—benefit analysis of retroperitoneoscopic adrenalectomy RPA versus the minimally invasive transperitoneal access LTA approach is currently lacking. We hypothesized that RPA is more cost effective than LTA; promising significant savings for the healthcare system in an era of ever more limited resources. We performed a monocentric retrospective observational cohort study based on data from our Endocrine Surgery Registry.
Patients who were operated upon between and were included. After pair-matching, both cohorts RPA vs. LTA were compared for perioperative variables and treatment costs process cost calculation , revenue and profit. Two homogenous cohorts of 43 patients each RPA vs. LTA were identified following matching. Patient characteristics between the cohorts were comparable. The duration of inpatient treatment and comorbidities significantly influenced the cost of treatment and the overall profit.
With an annual growth rate of 3. As surgically treatable diseases are expected to account for two thirds of the global lost years by [ 6 ], efforts to investigate and control costs would be wise to focus on surgical care, particularly in the area of minimally invasive surgery, where highly specialized tools may potentially lead to higher costs than traditional open surgery.
This is further complicated by a lack of published literature on which cost estimation models are most suitable [ 4 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. While some of the operative and perioperative costs associated with retroperitoneoscopic adrenalectomy RPA and the minimally invasive transperitoneal access approach LTA have been reported [ 16 ], a comprehensive cost—benefit analysis directly comparing both procedures is lacking.
Moreover, the published literature does not address revenue and profit. Meta-analyses proved RPA to be associated with lower long-term complications, a shorter hospital stay and duration of surgery and less postoperative pain [ 16 , 17 , 18 , 19 , 20 , 21 , 22 ].
