Cost-effectiveness of gasless laparoscopy as a means to increase provision of minimally invasive surgery for abdominal conditions in rural North-East India
Laparoscopic surgery, a minimally invasive technique to treat abdominal conditions, has been shown to produce equivalent safety and efficacy with quicker return to normal function compared to open surgery. As such, it is widely accepted as a cost-effective alternative to open surgery for many abdomi...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2022-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9348710/?tool=EBI |
| _version_ | 1828149891608608768 |
|---|---|
| author | Bryony Dawkins Noel Aruparayil Tim Ensor Jesudian Gnanaraj Julia Brown David Jayne Bethany Shinkins |
| author_facet | Bryony Dawkins Noel Aruparayil Tim Ensor Jesudian Gnanaraj Julia Brown David Jayne Bethany Shinkins |
| author_sort | Bryony Dawkins |
| collection | DOAJ |
| description | Laparoscopic surgery, a minimally invasive technique to treat abdominal conditions, has been shown to produce equivalent safety and efficacy with quicker return to normal function compared to open surgery. As such, it is widely accepted as a cost-effective alternative to open surgery for many abdominal conditions. However, access to laparoscopic surgery in rural North-East India is limited, in part due to limited equipment, unreliable supplies of CO2 gas, lack of surgical expertise and a shortage of anaesthetists. We evaluate the cost-effectiveness of gasless laparoscopy as a means to increase provision of minimally invasive surgery (MIS) for abdominal conditions in rural North-East India. A decision tree model was developed to compare costs, evaluated from a patient perspective, and health outcomes, disability adjusted life years (DALYs), associated with gasless laparoscopy, conventional laparoscopy or open abdominal surgery in rural North-East India. Results indicate that MIS (performed by conventional or gasless laparoscopy) is less costly and produces better outcomes, fewer DALYs, than open surgery. These results were consistent even when gasless laparoscopy was analysed using least favourable data from the literature. Scaling up provision of MIS through increased access to gasless laparoscopy would reduce the cost burden to patients and increase DALYs averted. Based on a sample of 12 facilities in the North-East region, if scale up was achieved so that all essential surgeries amenable to laparoscopic surgery were performed as such (using conventional or gasless laparoscopy), 64% of DALYS related to these surgeries could be averted, equating to an additional 454.8 DALYs averted in these facilities alone. The results indicate that gasless laparoscopy is likely to be a cost-effective alternative to open surgery for abdominal conditions in rural North-East India and provides a possible bridge to the adoption of full laparoscopic services. |
| first_indexed | 2024-04-11T21:36:41Z |
| format | Article |
| id | doaj.art-7c9b32cc2a9f4384ac3a1afc3c90c13b |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-11T21:36:41Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-7c9b32cc2a9f4384ac3a1afc3c90c13b2022-12-22T04:01:44ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01178Cost-effectiveness of gasless laparoscopy as a means to increase provision of minimally invasive surgery for abdominal conditions in rural North-East IndiaBryony DawkinsNoel AruparayilTim EnsorJesudian GnanarajJulia BrownDavid JayneBethany ShinkinsLaparoscopic surgery, a minimally invasive technique to treat abdominal conditions, has been shown to produce equivalent safety and efficacy with quicker return to normal function compared to open surgery. As such, it is widely accepted as a cost-effective alternative to open surgery for many abdominal conditions. However, access to laparoscopic surgery in rural North-East India is limited, in part due to limited equipment, unreliable supplies of CO2 gas, lack of surgical expertise and a shortage of anaesthetists. We evaluate the cost-effectiveness of gasless laparoscopy as a means to increase provision of minimally invasive surgery (MIS) for abdominal conditions in rural North-East India. A decision tree model was developed to compare costs, evaluated from a patient perspective, and health outcomes, disability adjusted life years (DALYs), associated with gasless laparoscopy, conventional laparoscopy or open abdominal surgery in rural North-East India. Results indicate that MIS (performed by conventional or gasless laparoscopy) is less costly and produces better outcomes, fewer DALYs, than open surgery. These results were consistent even when gasless laparoscopy was analysed using least favourable data from the literature. Scaling up provision of MIS through increased access to gasless laparoscopy would reduce the cost burden to patients and increase DALYs averted. Based on a sample of 12 facilities in the North-East region, if scale up was achieved so that all essential surgeries amenable to laparoscopic surgery were performed as such (using conventional or gasless laparoscopy), 64% of DALYS related to these surgeries could be averted, equating to an additional 454.8 DALYs averted in these facilities alone. The results indicate that gasless laparoscopy is likely to be a cost-effective alternative to open surgery for abdominal conditions in rural North-East India and provides a possible bridge to the adoption of full laparoscopic services.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9348710/?tool=EBI |
| spellingShingle | Bryony Dawkins Noel Aruparayil Tim Ensor Jesudian Gnanaraj Julia Brown David Jayne Bethany Shinkins Cost-effectiveness of gasless laparoscopy as a means to increase provision of minimally invasive surgery for abdominal conditions in rural North-East India PLoS ONE |
| title | Cost-effectiveness of gasless laparoscopy as a means to increase provision of minimally invasive surgery for abdominal conditions in rural North-East India |
| title_full | Cost-effectiveness of gasless laparoscopy as a means to increase provision of minimally invasive surgery for abdominal conditions in rural North-East India |
| title_fullStr | Cost-effectiveness of gasless laparoscopy as a means to increase provision of minimally invasive surgery for abdominal conditions in rural North-East India |
| title_full_unstemmed | Cost-effectiveness of gasless laparoscopy as a means to increase provision of minimally invasive surgery for abdominal conditions in rural North-East India |
| title_short | Cost-effectiveness of gasless laparoscopy as a means to increase provision of minimally invasive surgery for abdominal conditions in rural North-East India |
| title_sort | cost effectiveness of gasless laparoscopy as a means to increase provision of minimally invasive surgery for abdominal conditions in rural north east india |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9348710/?tool=EBI |
| work_keys_str_mv | AT bryonydawkins costeffectivenessofgaslesslaparoscopyasameanstoincreaseprovisionofminimallyinvasivesurgeryforabdominalconditionsinruralnortheastindia AT noelaruparayil costeffectivenessofgaslesslaparoscopyasameanstoincreaseprovisionofminimallyinvasivesurgeryforabdominalconditionsinruralnortheastindia AT timensor costeffectivenessofgaslesslaparoscopyasameanstoincreaseprovisionofminimallyinvasivesurgeryforabdominalconditionsinruralnortheastindia AT jesudiangnanaraj costeffectivenessofgaslesslaparoscopyasameanstoincreaseprovisionofminimallyinvasivesurgeryforabdominalconditionsinruralnortheastindia AT juliabrown costeffectivenessofgaslesslaparoscopyasameanstoincreaseprovisionofminimallyinvasivesurgeryforabdominalconditionsinruralnortheastindia AT davidjayne costeffectivenessofgaslesslaparoscopyasameanstoincreaseprovisionofminimallyinvasivesurgeryforabdominalconditionsinruralnortheastindia AT bethanyshinkins costeffectivenessofgaslesslaparoscopyasameanstoincreaseprovisionofminimallyinvasivesurgeryforabdominalconditionsinruralnortheastindia |