Zachary Penny

North Middlesex University Hospital
United States

Abstract Title: vNotes Vs Conventional Laparoscopic Ovarian Cystectomy For Dermoids Cost Comparisons Of Two Minimally Invasive Routes

Biography:

Zachary Penny is a dedicated medical student at St. George's University International Medical School, pursuing a career in healthcare with a passion for women s health. A recipient of the honorable Posse Foundation full-tuition scholarship, Penny graduated from Dickinson College, where they honed their skills in collaborative research. Committed to making a meaningful impact in medicine, Penny is enthusiastic about blending academic excellence with compassionate care.

Research Interest:

Corresponding author: Dr Wai Yoong, Department of Obstetrics and Gynecology, North Middlesex University Hospital, London, UK
Objective: While conventional laparoscopy (CL) is the benchmark for ovarian cystectomy, vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) is emerging as a viable alternative route with good optical visibility, avoidance of abdominal trocar incisions, better cosmesis, less pain and rapid recovery. The aim of this study was to compare expenditure of performing vNOTES vs CL cystectomy for an ovarian teratoma based on equipment, surgical assistants as well as theatre and recovery bed occupancy.
Study population: Outcome data from 13 cases of vNOTES and 13 cases of CL cystectomy for ovarian dermoid cysts
Methods: Data collected from the hospital electronic records and physical notes included age, body mass index (BMI), dermoid size, duration of surgery, estimated blood loss (EBL), length of stay, intra and postoperative complications. Expenditure for equipment, additional assistants, theatre time, bed occupancy and sick leave were calculated using unit costs data verified with NHS England Cost Collection website
Results: The median age (38 vs 37.5yrs), BMI (29.1 vs 26.9kg/m3), EBL (100 vs 100mls) and teratoma size (7.7 vs 7cm) were similar between the two groups (all p>0.05) but vNOTES patients had significantly shorter median theatre duration (40 vs 67mins) and length of stay (3.5 vs 5.5hrs) with less patients requiring post-operative opioids (16 vs 39%) (all p<0.05). There were no complications in either group. Adnexectomy performed via vNOTES cost 30% less than CL ($2,322.89 vs. $ 3,314.91) and the unit expenditures are listed in table 1. The higher estimate for CL is attributed to longer theatre utilization, the need for a second assistant and use of endoscopic bags to minimize intraperitoneal spillage.
Conclusion: Shorter theatre duration and length of stay, avoidance of abdominal trocar incisions, less pain and more rapid recovery, allied with 30% lower cost favor the adoption vNOTES as a preferred option for minimally invasive adnexectomy.