Comparison between the open and the laparoscopic approach in the primary ventral hernia repair: a systematic review and meta-analysis
Abstract
Background Ventral hernia repair underwent various developments in the previous decade. Laparoscopic primary ventral hernia repair may be an alternative to open repair since it prevents large abdominal incisions. However, whether laparoscopy improves clinical outcomes has not been systematically assessed. Objectives The aim is to compare the clinical outcomes of the laparoscopic versus open approach of primary ventral hernias. Methods A systematic search of MEDLINE (PubMed), Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted in February 2023. All randomized controlled trials comparing laparoscopy with the open approach in patients with a primary ventral hernia were included. A fixed-effects meta-analysis of risk ratios was performed for hernia recurrence, local infection, wound dehiscence, and local seroma. Meta-analysis for weighted mean differences was performed for postoperative pain, duration of surgery, length of hospital stay, and time until return to work. Results Nine studies were included in the systematic review and meta-analysis. The overall hernia recurrence was twice less likely to occur in laparoscopy (RR = 0.49; 95%CI = 0.32–0.74; p < 0.001; I ^2 = 29%). Local infection (RR = 0.30; 95%CI = 0.19–0.49; p < 0.001; I ^2 = 0%), wound dehiscence (RR = 0.08; 95%CI = 0.02–0.32; p < 0.001; I ^2 = 0%), and local seroma (RR = 0.34; 95%CI = 0.19–0.59; p < 0.001; I ^2 = 14%) were also significantly less likely in patients undergoing…
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