ArticleSurgical endoscopy2026
Surgeon practice variation drives disposable supply cost in inguinal hernia repair: a real-world health system analysis (2017-2025).
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAs robotic platform adoption expands, differences in procedural cost for inguinal hernia repair are frequently attributed to surgical technology. However, the relative contribution of surgical approach versus surgeon-specific practice patterns to cost variation remains incompletely defined.
methodsWe conducted a retrospective cohort study of adults undergoing inguinal hernia repair within a multi-hospital healthcare system from 2017 to 2025. Mixed-effects regression models evaluated direct disposable supply cost and operating room time, adjusting for patient characteristics, case complexity, surgeon experience, calendar year, and clustering at both surgeon and hospital levels.
resultsThe cohort included 14,313 repairs performed by 137 surgeons across 29 hospitals (open 43.8%, robotic 46.7%, laparoscopic 9.5%). Robotic utilization increased from 8.7 to 66.0% by 2024, largely replacing laparoscopy; 62% of surgeons performed only one approach. After adjustment, mean direct disposable supply cost was $567 for open, $1,527 for robotic, and $1,741 for laparoscopic repair (robot vs. laparoscopic: - $213, 95% CI - $274 to - $153, p < 0.001). Adjusted mean operating room time was 119 min for open, 142 for robotic, and 120 for laparoscopic repair (robotic vs. open: + 23.1 min, p < 0.001). Robotic repair was associated with lower odds of overnight admission (OR 0.73, 95% CI 0.55-0.96, p = 0.022). Within each platform, surgeon-level cost deviations ranged up to $777 (open) and $196 (robotic) above the platform mean, often exceeding between-platform differences. Standardized per 1,000 cases, combined potentially avoidable cost (supplies plus operating room time at $75/min) was $638,000 for robotic repairs.
conclusionsSurgeon-level practice variation is a major contributor to procedural cost variation in inguinal hernia repair and may provide an important target for value-improvement efforts. Because most surgeons in this cohort performed only one approach, such efforts are likely to have the greatest practical impact when directed at preference-card standardization and peer benchmarking within the platforms where surgeons already practice.
Indexed as
Identifiers
42554866What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.