Laparoscopic versus open appendectomy in children: the effect of surgical technique on healthcare costs

• Laparoscopic appendectomy performed in children results in higher surgical supply, operating room, and total hospital charges compared with open appendectomy.
• No differences in outcomes and complications between the laparoscopic and open appendectomy group were observed in our study.
• Cost-effective surgical techniques should be used in laparoscopic appendectomy to reduce the equipment costs.

BackgroundReducing healthcare costs while maintaining quality of care is one of the challenges of the current healthcare system. The purpose of this study was to compare the hospital charges accrued following laparoscopic (LA) and open (OA) appendectomies in the pediatric population.MethodsWe retrospectively reviewed all pediatric appendectomies (n = 264) performed from 2007 to 2013 at a single academic center. Subgroup analysis on charges and costs was performed on perforated and nonperforated LA and OA.ResultsA total of 195 (73.9%) appendectomies were performed laparoscopically. LA in both perforated and nonperforated groups was associated with higher surgical supply, operating room, and total hospital charges compared with OA. Surgical supply costs to the facility were higher by an average of $1,000 for both nonperforated and perforated appendicitis in the LA group. Length of stay and postoperative complications were comparable within all groups.ConclusionsIn this study, LA is associated with significantly higher surgical costs and charges than OA without improvement in outcomes. Investigation into cost reduction strategies of laparoscopy should be a component of future clinical appendicitis research.