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In our hypothetical cohort of 10,000 women, there were 64 cases of ovarian rupture in the MIS group and 53 in the laparotomy group, while there were 26 cancer related deaths in the MIS group and 25 in the laparotomy group. MIS was more effective than laparotomy (188,462 QALYs for MIS versus 187,631 QALYs for laparotomy). Thus, MIS was a dominant strategy, being both less costly and more effective than laparotomy. These results were robust in a variety of sensitivity analyses. MIS constitutes a cost-effective management strategy for women
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