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Kosten- und Risikoanalyse der Hernienreparation

Laparoskopische IPOM- vs. offene Sublay-Technik

Cost-effectiveness of hernia repair

IPOM versus open sublay mesh technique

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Zusammenfassung

Im Vergleich zur konventionellen Technik mittels offener Netzimplantation (Sublay-Technik) können mit der laparoskopischen intraperitonealen Onlay-Mesh (IPOM)-Technik Narbenhernien und Nabelhernien, insbesondere bei adipösen Patienten, mit einem geringeren Operationstrauma erfolgreich versorgt werden. Der kürzeren Operationsdauer und der schnelleren postoperativen Rekonvaleszenz der Patienten und dementsprechend kürzeren Krankenhausverweildauer stehen höhere (Material-)Kosten entgegen. Diese Studie soll anhand einer vergleichenden Analyse beider Operationstechniken unter Berücksichtigung des DRG-Systems die perioperativen Vor- und Nachteile beider Methoden aufzeigen.

Abstract

In comparison to the conventional technique of incisional or umbilical hernia repair with sublay mesh augmentation, incisional hernias in obese patients can be surgically treated with minor surgical trauma by laparoscopic intraperitoneal onlay mesh (IPOM) repair. However, although shortened operation time, hospital stay and faster postoperative reconvalescence might be possible with IPOM repair, the economic calculation including mesh costs is significantly higher. In this study the two operation techniques were compared and the perioperative advantages and disadvantages of both methods were analyzed based on the German diagnosis-related groups (DRG) system.

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Authors and Affiliations

  1. Klinik und Poliklinik für Allgemein-, Viszeral-, Thorax- und Gefäßchirurgie , Universitätsklinik Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Deutschland

    M. Overhaus, C.B. Schaudienst, Y. Nohl, T.O. Vilz, A. Hirner, J. Standop, J.C. Kalff & N. Schäfer

  2. Abteilung für Allgemein-, Viszeral- und Gefäßchirurgie, Johanniter Krankenhaus, Bonn, Deutschland

    A. Türler

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  1. M. Overhaus
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  2. C.B. Schaudienst
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  3. Y. Nohl
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  4. T.O. Vilz
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  5. A. Hirner
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  7. A. Türler
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  8. J.C. Kalff
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  9. N. Schäfer
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Correspondence to M. Overhaus.

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Overhaus, M., Schaudienst, C., Nohl, Y. et al. Kosten- und Risikoanalyse der Hernienreparation. Chirurg 82, 813–819 (2011). https://doi.org/10.1007/s00104-011-2076-x

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  • DOI: https://doi.org/10.1007/s00104-011-2076-x

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