Office hysteroscopic sterilization compared with laparoscopic sterilization: A critical cost analysis

STUDY OBJECTIVE: To evaluate the actual cost difference in performing Essure hysteroscopic sterilization in the office compared with ambulatory surgery using laparoscopic sterilization in the operating room. DESIGN: Cost-comparison analysis (Canadian Task Force classification III). SETTING: University hospital and affiliated outpatient office. INTERVENTIONS: Hysteroscopic placement of Essure device in an office setting and laparoscopic tubal ligation for permanent sterilization. MEASUREMENTS AND MAIN RESULTS: The various costs associated with the two procedures at our institution were compiled, and a direct cost comparison was made. We used actual institutional costs of the procedures, not billing or reimbursement. We found laparoscopic tubal ligations to cost $3449 compared with hysteroscopic placement of the Essure device that costs $1374 yielding a $2075 difference between the procedures. CONCLUSION: In our institution and in our experience, office-hysteroscopic placement of the Essure device is a more cost-effective method than laparoscopic tubal ligation.