Covidien, a leading global provider of healthcare products, today announced study data demonstrating that use of its Endo Stitch automated suturing device lowers mean hospital costs and operating room (OR) time during total laparoscopic hysterectomies treating benign conditions.
Using the Endo Stitch device in such procedures was associated with lowering overall hospitalization costs by approximately $1,800 and reducing OR time by approximately 40 minutes, on average, when compared to those same procedures performed with robotic assistance.
The results, presented at the American Association of Gynecologic Laparoscopists (AAGL) 40th Global Congress of Minimally Invasive Gynecology, also revealed that mean operating room time in cases where Covidien’s Endo Stitch device was used in such procedures was about 20 minutes less, when compared to procedures where neither a robot nor an Endo Stitch device was utilized.
Laparoscopic suturing is a vital skill for advanced laparoscopic surgeons, but it is considered difficult to master when using traditional manual techniques. Automated suturing devices, such as Covidien’s Endo Stitch, assist in the process and have been shown to shorten the time needed to suture internal tissues through ports, when compared to other techniques.
According to the AAGL, fewer than 15% of the 600,000 hysterectomy procedures performed annually in the United States are done laparoscopically, largely due to lack of required training during a surgeon’s formal education program.1
About the Study
The study was a retrospective data analysis that compared the reported overall hospital costs and OR time when utilizing the Endo Stitch device, versus using robotic techniques, during total laparoscopic hysterectomy in benign cases, as well as using neither the Endo Stitch device nor robotic techniques in such cases.
The study analyzed inpatient hospitalization data from January 1, 2009, to June 30, 2010, taken from Premier’s Perspective™ Database (PPD). Multivariate analysis using Generalized Estimating Equations was used for the analysis, controlling for patient demographics and hospital characteristics. The analysis included clustering of patients receiving care from the same hospital.
A total of 5,731 patients were identified who underwent a total laparoscopic hysterectomy (primary ICD-9-CM code 68.41) without a primary diagnosis of cervical, uterine, ovarian or tubal cancers. Of those procedures, 13% (n=727) utilized the Endo Stitch device, 50% (n=2,853) used robotic assistance and 37% (n=2,151) used neither the Endo Stitch device nor robotic assistance during the procedure.
Outcomes were adjusted for patient age, race, severity of illness, co-morbidities, hospital bed-size, census region and teaching status, and clustering by provider. The Endo Stitch device use compared to robot use resulted in lower adjusted overall costs and less OR time: $7,820 vs. $9,689 (p=0.0096) and 173 minutes vs. 216 minutes (p = 0.0003), respectively.
Endo Stitch device use compared to neither devices used resulted in lower OR time: 173 minutes vs. 194 minutes (p=0.0022), respectively. As with other observational studies, some important factors may not have been controlled for in the analysis, therefore no direct causation can be definitively concluded.