Medicoeconomic evaluation of inguinal hernia repair: Shouldice repair vs laparoscopy.

Between May 1994 and September 1995, 64 men were included in a randomized prospective study comparing conventional Shouldice repair (S group) and transperitoneal laparoscopic repair with polypropylene mesh (L group). Cost evaluation was divided into distinct parts: drugs, non usable surgical materials, medico-technical procedures food and employees costs. In group S, mean operating time was 56', total cost was 3 922 FF in the case of unilateral hernia and 4 808 FF and respectively 77' in the case of bilateral hernia. In group L, mean operative time was 89', total cost 8 949 FF (disposable trocars) and 7 136 FF (non-disposable trocars) in the case of unilateral hernia and 116', 9 570 FF and 7 763 FF in case of bilateral hernia. Postoperative stay was 4.2 days in group S and 4 days in group L. Return to work was 28.6 days in group L and 35.5 days in group S (ns). In conclusion, laparoscopic hernia repair does not decrease post operative pain, hospital stay and return to work, but is twice as expensive.