The economics of laparoscopic antireflux operations compared with open surgery

In Sweden laparoscopic antireflux surgery started in 1991, and within four years replaced the open procedure as the method of choice. It is, however, not yet settled which of the two techniques is most cost effective. To comp are these two operations in economic terms we studied all reports up to Sep tember 1997 as well as the register in the epidemiological unit of the Nati onal Board of Health and Welfare (EpC). We found numerous reports on consec utive series of laparoscopic procedures, several non-randomised studies, an d only one randomised prospective study comparing open and laparoscopic ant ireflux surgery. The few studies about the economics of antireflux surgery indicated that hospital costs were equal or less for the laparoscopic proce dure. If one adds the costs from loss of production (sick leave) it will be an even more favourable outcome for the laparoscopic treatment. The figures from EpC showed that antireflux surgery is done infrequently in many surgical departments. This may have a substantial influence on the ec onomic outcome as well as the effectiveness of antireflux surgery in Sweden . Few studies have compared open and laparoscopic methods from an economic perspective. As a tool for cost benefit analysis these reports are incomple te.