OC-067 COST-EFFECTIVENESS AND CLINICAL OUTCOMES ANALYSIS OF LAPAROSCOPIC TOTAL EXTRAPERITONEAL (TEP) AND LAPAROSCOPIC TRANS- ABDOMINAL PREPERITONEAL (TAPP) INGUINAL HERNIA REPAIR

Objective A cost-effective analysis of the laparoscopic total extraperitoneal (TEP) repair and laparoscopic trans- abdominal preperitoneal (TAPP) laparoscopic versus open inguinal hernia repair is still not well addressed. The aim of this study is to compare the clinical and cost-effective outcomes of TEP repair and TAPP repair for unilateral inguinal hernia. Methods This is a clinical and cost-effectiveness analysis within a randomized prospective study conducted at Sanchinarro University Hospital. Cases of primary, reducible unilaterl inguinal hernia were included and randomized using a simple randomization program. The outcome parameters included surgical and postoperative costs, quality adjusted life years (QALY), and incremental cost per QALY gained or the incremental cost effectiveness ratio. Results Between January 2020 and January 2023, 60 patients were enrolled in this study (30 of them underwent TEP and 30 TAPP). The TEP procedure had less early postoperative pain (p=0.035). The operative time was higher in the TAPP group with respecto to the TEP group (p =0.05). The overall cost of TAPP procedure was higher compared with the TEP cost but without statically significance (883.93s vs 780 p>0,05). The mean QALYs at 1 year for TEP (0.7094) was higher than that associated with TAPP (0.541) (p=0,038). At a willingness-to-pay threshold of 20,000 s and 30,000 s, there was a 85.28% and 91.44% probability that TEP was more cost-effective relative to TAPP. Conclusions The TEP procedure for unilateral and bilateral inguinal hernia appears to be more cost-effective compared with TAPP.