Meta-Analysis

Meta-analysis of randomized controlled trials comparing open and laparoscopic ventral and incisional hernia repair with mesh

  1. S. S. Forbes1,2,3,
  2. C. Eskicioglu1,2,3,
  3. R. S. McLeod1,2,3,4,
  4. A. Okrainec1,5,*

Article first published online: 9 JUL 2009

DOI: 10.1002/bjs.6668

Issue

British Journal of Surgery

British Journal of Surgery

Volume 96, Issue 8, pages 851–858, August 2009

Additional Information

How to Cite

Forbes, S. S., Eskicioglu, C., McLeod, R. S. and Okrainec, A. (2009), Meta-analysis of randomized controlled trials comparing open and laparoscopic ventral and incisional hernia repair with mesh. British Journal of Surgery, 96: 851–858. doi: 10.1002/bjs.6668

Author Information

  1. 1

    Department of Surgery, Toronto, Ontario, Canada

  2. 2

    Department of Health Policy, Management, and Evaluation, University of Toronto, Ontario, Canada

  3. 3

    Department of Dr Zane Cohen Digestive Diseases Clinical Research Centre, Toronto, Ontario, Canada

  4. 4

    Department of Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada

  5. 5

    Department of Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada

*Toronto Western Hospital, Main Pavillion 8-325, 399 Bathurst Street, Toronto, Ontario M8Y 1E8, Canada

Publication History

  1. Issue published online: 9 JUL 2009
  2. Article first published online: 9 JUL 2009
  3. Manuscript Accepted: 28 MAR 2009

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Laparoscopy at least as safe as open repair

Abstract

Background:

Laparoscopic ventral and incisional hernia repair has been reported in a number of small trials to have equivalent or superior outcomes to open repair.

Methods:

Randomized controlled trials comparing laparoscopic and open incisional or ventral hernia repair with mesh that included data on effectiveness and safety were included in a meta-analysis.

Results:

Eight studies met the inclusion criteria. There was no difference between groups in hernia recurrence rates (relative risk 1·02 (95 per cent confidence interval (c.i.) 0·41 to 2·54)). Duration of surgery varied. Mean length of hospital stay was shorter after laparoscopic repair in six of the included studies; the longest mean stay was 5·7 days for laparoscopic and 10 days for open surgery. Laparoscopic hernia repair was associated with fewer wound infections (relative risk 0·22 (95 per cent c.i. 0·09 to 0·54)), and a trend toward fewer haemorrhagic complications and infections requiring mesh removal.

Conclusion:

Laparoscopic repair of ventral and incisional hernia is at least as effective, if not superior to, the open approach in a number of outcomes. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

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