Laparoscopic Adrenalectomy: A Cost Analysis of Three Approaches

Laparoscopic adrenalectomy (LA) is the current standard for treatment of benign adrenal disease and is performed more often now in the setting of malignant disease. Three surgical approaches, the lateral transperitoneal technique, the lateral retroperitoneal technique, and the posterior technique are utilized commonly. While advantages of each approach are advocated, a cost analysis is not available. This article analyzes the operating costs of the three approaches. The operative costs of 51 unilateral LA at the Cleveland Clinic Foundation from 1998 to 2002 were analyzed for comparison. Patients were grouped according to one of the three laparoscopic approaches - transperitoneal (group A), lateral retroperitoneal (group B), and posterior (group C). For each group, n = 17. Perioperative characteristics and operative cost were analyzed. The groups were compared using single factor ANOVA analysis. Significance was assigned for P < 0.05. The average costs of unilateral LA were $2,885, $3,219, and $2,850 for g...