Systematic review of the clinical effectiveness and cost-effectiveness of laparoscopic surgery for the repair of inguinal hernia (Update) - NICE Technology Assessment Report

McCormack K, Wake B, Perez J, Fraser C, Cook J, McIntosh E, Vale L, Grant A
Record ID 32005001010
English
Authors' objectives:

To determine whether laparoscopic methods are more effective and cost-effective than open mesh methods of inguinal hernia repair, and then whether laparoscopic transabdominal preperitoneal (TAPP) repair is more effective and cost-effective than laparoscopic totally extraperitoneal (TEP).

Authors' recommendations: For the management of unilateral hernias, the base-case analysis and most of the sensitivity analysis suggest that open flat mesh is the least costly option but provides less quality adjusted life years (QALYs) than TEP or TAPP. TEP is likely to dominate TAPP (on average TEP is estimated to be less costly and more effective). It is likely that, for management of symptomatic bilateral hernias, laparoscopic repair would be more cost-effective as differences in operation time (a key cost driver) may be reduced and differences in convalescence time are more marked (hence QALYs will increase) for laparoscopic compared with open mesh repair. When possible repair of contralateral occult hernias is takeninto account, TEP repair is most likely to be considered cost-effective at threshold values for the cost per additional QALY above £20,000. The increased adoption of laparoscopic techniques may allow patients
Details
Project Status: Completed
URL for project: http://www.hta.ac.uk/1376
Year Published: 2005
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Cost-Benefit Analysis
  • Quality-Adjusted Life Years
  • Randomized Controlled Trials as Topic
  • Recurrence
  • State Medicine
  • Treatment Outcome
  • Hernia, Inguinal
  • Laparoscopy
  • Surgical Mesh
Contact
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name: journals.library@nihr.ac.uk
Contact Email: journals.library@nihr.ac.uk
Copyright: 2009 Queen's Printer and Controller of HMSO
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