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Anne C. Fischer, MD, PhD

Arch Surg. 2007;142(1):62.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In this era of evidence-driven best practices, the cost analysis by Lukish and colleagues of 2 LA methods is a timely and innovative study that addresses the higher costs typically associated with laparoscopy. A meta-analysis¹ of 54 controlled trials did find that laparoscopy afforded a reduction in postoperative pain, decreased LOS, earlier return to normal activities, and fewer wound infections, with the caveat of increased ST. The pediatric trials likewise did not differ from adult trials in these outcomes. Thus, the argument for the cost-effectiveness of laparoscopy is that the decreased LOS offsets the increased costs incurred by nonreusable instrumentation and increased ST.^2-3

Lukish and colleagues found no difference in clinical outcomes between the EL and ES methods, but there was a compelling cost disparity of $572 per case favoring ES as a more cost-effective method. To put that value in perspective, the financial difference . . . [Full Text of this Article]

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