A Literature-based Cost-effectiveness Analysis of Device-assisted Suturing Versus Needle-driven Suturing During Laparotomy Closure

Overview

Journal Hernia

Publisher Springer

Date 2025 Jan 23

PMID 39847140

Authors

Zin Min Thet Lwin

Gabriel Borner

Sophia Verheij-Engqvist

George Keel

Affiliations

Soon will be listed here.

Abstract

Purpose: Small-bites suturing technique for laparotomy closure is now recommended as the standard of care. However, uptake of the practice remains slow. A medical technology called the SutureTOOL has been developed which can facilitate implementation of small-bites. The aim of the study was to compare the economic and clinical outcomes of laparotomy closure for patients using manual needle-driver suturing versus device-assisted suturing (SutureTOOL) following open abdominal surgery.

Methods: This cost-effectiveness analysis comparing device-assisted suturing to needle-driver suturing was performed from a healthcare perspective within Sweden, France, the UK, and the US. A decision tree model was developed to implement the analysis.

Results: The SutureTOOL was found to be cost-effective, reducing costs between 22% and 40% across country contexts. Savings were associated with reduced post-operative complications and reductions in operating room time. Improvements in quality of life were minimal and not clinically significant, likely because of the short time horizon.

Conclusion: Cost-effectiveness was largely due to cost savings. Prior to procurement, hospitals should test the device to ensure that small-bite rates and reductions in operation time are replicable within their clinical context. If so, the device will improve quality of care for laparotomy wound closure.

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