Financial analysis of needlescopic versus open adrenalectomy

Purpose: Needlescopic adrenalectomy, partially incorporating 2 mm. instrume ntation, is currently our preferred technique for transperitoneal endoscopi c adrenalectomy. Although this minimally invasive technique results in decr eased morbidity and shorter hospital stay, to our knowledge financial impli cations vis-a-vis open adrenalectomy have not been elucidated. We retrospec tively compared the costs of needlescopic adrenalectomy to traditional open adrenalectomy. Materials and Methods: From September 1997 through March 1998, 15 patients underwent needlescopic adrenalectomy. Financial records of these patients w ere compared to those of 15 contemporary patients undergoing open adrenalec tomy between January 1995 and May 1997. Adrenal pathology and tumor size we re comparable between the 2 groups. Yearly costs were adjusted for inflatio n to 1998 dollars using a 4% annual rate. Needlescopic financial data are e xpressed asa ratio of open adrenalectomy costs, which are expressed as a un it of 1. Results: Overall, needlescopic adrenalectomy resulted in a 17.9% decrease i n total hospital costs compared to open adrenalectomy. While the needlescop ic approach was associated with an 18.1% increase in intraoperative costs, postoperative costs were 63.4% lower. Conclusions: These data demonstrate that in addition to providing a shorter hospital stay, decreased morbidity and quicker recovery, needlescopic adre nalectomy also is 17.9% less expensive than open adrenalectomy.