Assessment of Costs Associated With Outpatient Total Laparoscopic Hysterectomy

Objective: To assess the costs associated with the performance of outpatient total laparoscopic hysterectomy Methods: This was a retrospective cohort study involving 224 consecutive patients undergoing total laparoscopic hysterectomy (TLH) by a single surgeon in the Regina General Hospital. Outcomes included costs associated with the initial procedure as well as those associated with any intraoperative or postoperative complications. Results: The mean age of the patients was 42.7 years. The mean uterine weight was 205 grams (range 69-1163 g), the mean operating time was 79 minutes, and the mean blood loss was 89 cc. The mean postoperative stay in the day surgery unit (DSU) was 354 minutes. Ten patients required admission from the DSU, and nine patients were admitted more than 24 hours after surgery. The total number of admission days was 24, which cost $ 21 900. The total cost of all disposables was $ 127 373 and the cost associated with the stays in day surgery was $ 89 600. The total cost for the 224 TLH procedures was $ 238 573, and the average cost per TLH was $ 1065. Conclusion: Outpatient TLH can be completed safely and with costs that are lower than those incurred by patients having short-stay vaginal hysterectomy in our institution. Outpatient TLH offers the opportunity to save health care costs and a procedure with excellent results.