E-Posters-Sacrocolpopexy Costs and Outcomes with Enhanced Recovery After Surgery

Sacrocolpopexy Costs and Outcomes with Enhanced Recovery After Surgery - Mary V. Baker, MD, MBA

Pdf Summary

The study aimed to compare the outcomes and costs of open sacrocolpopexy (ASC) and robotic sacrocolpopexy (RSC) after implementing Enhanced Recovery After Surgery (ERAS) protocols. The results showed that the mean length of stay decreased significantly with ERAS and liposomal bupivacaine, resulting in lower costs for ASC compared to RSC. However, ASC patients required more opiates postoperatively. Complication rates were similar between the two approaches, but surgical and patient satisfaction outcomes were not compared in this study. Overall, ASC may be considered a cost-effective alternative to RSC in appropriate patients. <br /><br />The study included patients who underwent ASC or RSC between January 2014 and November 2017, excluding those with prior sacrocolpopexy or concurrent pouch of Douglas repair/rectopexy. The surgical technique involved total hysterectomy and Ethicon Ultrapro mesh for both ASC and RSC, with the injection of liposomal bupivacaine during ASC skin closure.<br /><br />The study compared perioperative outcomes and costs between the two approaches. The results showed that the procedure length was significantly shorter for ASC, and ASC patients had a shorter length of stay compared to RSC. ASC patients also had higher usage of opiates postoperatively. The complication rates and readmission rates were similar for both approaches.<br /><br />In terms of cost analysis, the adjusted mean cost was significantly lower for ASC compared to RSC. Even when looking at subgroups with and without concurrent hysterectomy, RSC remained more expensive. <br /><br />Overall, open sacrocolpopexy (ASC) is the traditional approach, while robotic sacrocolpopexy (RSC) is becoming more preferred due to its minimally invasive nature and similar outcomes. However, with the implementation of ERAS and liposomal bupivacaine, ASC can be a cost-effective alternative to RSC in the right patients.

Keywords

open sacrocolpopexy

robotic sacrocolpopexy

Enhanced Recovery After Surgery

ERAS protocols

length of stay

costs

liposomal bupivacaine

opiates

complication rates

surgical satisfaction