Laparoscopic vs. laparotomic ovarian cystectomy in reproductive age women: an economic evaluation

Objective This study was carried out to assess both the efficacy and the economic advantages of two different surgical techniques in the treatment of ovarian cysts in women of reproductive age. Design A prospective randomized clinical study. Setting Endocrinological Gynaecology Department of the Catholic University of S. Cuore, Rome. Subjects These were 68 women of reproductive age (16–39 years) who were hospitalized for ovarian cysts which had persisted for at least 3 months, or who were noted to have an increase in ovarian volume detected by consecutive ultrasound investigations. Interventions Of these patients, 34 received laparotomic treatment using a Pfannewstiel incision and traditional techniques. The other 34 patients underwent a laparoscopic stripping of the capsule of the cyst with no sutures on the ovary. Results The two techniques showed similar levels of safety and efficacy. The comparison of direct and indirect costs for the two procedures showed an average total cost of $4940 for laparotomic surgery and $3543 for laparoscopy. Conclusions The present study demonstrates that ovarian cysts can be as well treated using laparoscopic access as with laparotomy, but with an average cost reduction of 28% for the former.