Cost comparison of fibrin sealant versus tack screws for mesh fixation in laparoscopic repair of inguinal hernia

Hospital Practice
Saswat PandaManuel G Ramirez

Abstract

Inguinal hernias of the abdominal wall are common accounting for 75% of all hernia defects. They can be treated with laparoscopic surgery using a transabdominal preperitoneal (TAPP) approach. However, in surgery there is some contention on how to conclude the hernia repair, as there are alternatives of using fibrin sealant (FS) or tack screws for fixation of a mesh implant over the defect in the abdominal wall. In this study, we evaluate the economic consequences of using FS vs. tacks for mesh fixation in TAPP inguinal hernia repair for the UK from a hospital perspective. The model was populated with clinical inputs (theater time, hospitalization days, occurrence of seroma, and neuralgia) from a previously conducted study comparing FS and tack screws in patients who had undergone TAPP hernia repair, and cost inputs from official government sources. One-way sensitivity analyses were also conducted to evaluate key drivers of cost analyses. The average cost per case treated with FS 2 mL Tisseel® and tack screws (ProTackTM) was £1,098 and £1,348, respectively, for resource expenses paid by the healthcare system. This would suggest a potential savings achieved of £249 per surgery using FS for mesh fixation. The sensitivity analysis ...Continue Reading

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Citations

Apr 25, 2019·BMJ Case Reports·Arnaldo Neves Santos SilvaJonathan R Morton

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