Técnica extraperitoneal comparada con IPOM plus: Análisis de costos evitados para optimizar el manejo de la hernia ventral por laparoscopia

Introduction. Costs in the extraperitoneal repair of ventral hernia by laparoscopy were analyzed from the perspective of the general health system of Colombia, in order to show the benefits of this approach and its economic impact, when compared with the most implemented technique, IPOM plus. Methods. A cost-benefit economic analysis was performed from the perspective of the General Social Security System in Health (SGSSS) of Colombia, comparing the costs of ventral hernia repair with the extraperitoneal technique, TAPP or TEP, against IPOM plus. The reference costs were taken as established in the rate manual of the Social Security Institute. Data were analyzed with Stata v.15. Results. Information from 109 procedures was collected and analyzed; 59 of the extraperitoneal group TAPP / TEP and 50 of IPOM plus group, carried out during the years 2015 to 2018, by the abdominal wall group of Clinica Colsanitas, identifying a saving of 69.8 % or cost-benefit results in favor of the extraperitoneal group. Discussion. The extraperitoneal approach in ventral hernia repair was considered a high cost-benefit strategy for the health system, validated by the experience of the abdominal wall group of Clinica Colsanitas, when compared with the usual approach. Given that the inputs used for dissection do not change, the prosthesis used for each of the techniques represents an important cost to consider, both for the system and health institutions.