Analysing the benefits of laparoscopic hernia repair compared to open repair: A meta-analysis of observational studies

Salvilla, Sarah A.; Thusu, Sundeep; Panesar, Sukhmeet S.
October 2012
Journal of Minimal Access Surgery;Oct-Dec2012, Vol. 8 Issue 4, p111
Academic Journal
BACKGROUND: The purpose of this study is to compare the difference of incidence of post-operative complications, operative time, length of stay and recurrence of patients undergoing laparoscopic or open repair of their ventral/incisional hernia a meta-analytic technique for observational studies. MATERIALS AND METHODS: A literature search was performed using Medline, PubMed, Embase and Cochrane databases for studies reported between 1998 and 2009 comparing laparoscopic and open surgery for the treatment of ventral (incisional) hernia. This meta-analysis of all the observational studies compared the post-operative complications recurrence rate and length of stay. The random effects model was used. Sensitivity and heterogeneity were analysed. RESULTS: Analysis of 15 observational studies comprising 2452 patients qualified for meta-analysis according to the study's inclusion criteria. Laparoscopic surgery was attempted in 1067 out of 2452. The results showed that the length of stay (odds ratio [OR], - 1.00; 95% confidence interval [CI], - 1.09 to - 0.91; P < 0.00001) and operative time (OR, 59.33; 95% CI, 58.55 to 60.11; P < 0.00001) was significantly lower in the laparoscopic group. The results also showed that there was a significant reduction in the formation of abscesses (OR, 0.38; 95% CI, 0.16 to 0.92; P = 0.03) and wound infections (OR, 0.49; 95% CI, 0.29 to 0.82;P = 0.007) post-operatively. There is a trend which indicates that the recurrence of the hernia using laparoscopic repair versus open repair was overall lower with the laparoscopic repair (OR, 0.48; 95% CI, 0.22 to 1.04; P = 0.06), however, this was not significant. CONCLUSION: Laparoscopic incisional hernia repair was associated with a reduced length of stay, operative time and lower incidence of abscess and wound infection post-operatively. This study also highlights the benefit of using observational studies as a form of research and its value as a tool in answering questions where large sample sizes of patient groups would be impossible to accumulate in a reasonable length of time.


Related Articles

  • Laparoscopic Morgagni Hernia Repair: How I Do It. Park, Adrian; Doyle, Courtney // Journal of Gastrointestinal Surgery;Oct2014, Vol. 18 Issue 10, p1858 

    Surgical repair of Morgagni hernias is recommended given their historically high risk of incarceration. Traditionally, such repair has been undertaken via laparotomy or thoracotomy or more recently, thoracoscopically or laparoscopically using mesh. Here, we describe a laparoscopic approach to...

  • The Role of Prophylactic Antibiotics in Laparoscopic Cholecystectomy in Preventing Postoperative Infection: A Meta-Analysis. Yan, Rui-Cheng; Shen, Shi-Qiang; Chen, Zu-Bing; Lin, Fu-Sheng; Riley, Jan // Journal of Laparoendoscopic & Advanced Surgical Techniques;May2011, Vol. 21 Issue 4, p301 

    Background: Although laparoscopic cholecystectomy (LC) is a common and widely applied technique, the use of antibiotics during the perioperative period in infection prevention remains controversial. In our study, a meta-analysis was performed to assess the impact of antibiotic prophylaxis on the...

  • The Efficacy and Safety of Different Kinds of Laparoscopic Cholecystectomy: A Network Meta Analysis of 43 Randomized Controlled Trials. Li, Lun; Tian, Jinhui; Tian, Hongliang; Sun, Rao; Wang, Quan; Yang, Kehu // PLoS ONE;Feb2014, Vol. 9 Issue 2, p1 

    Background and Objective: We conducted a network meta analysis (NMA) to compare different kinds of laparoscopic cholecystectomy [LC] (single port [SPLC], two ports [2PLC], three ports [3PLC], and four ports laparoscopic cholecystectomy [4PLC], and four ports mini-laparoscopic cholecystectomy...

  • Commentary: Laparoscopic Indirect Hernia Repair– The Ring Closure Method. Richards, William O. // Journal of Laparoendoscopic & Advanced Surgical Techniques;Oct2001, Vol. 11 Issue 5, p303 

    Focuses on a surgery with a laparoscopic ring closure technique for repair of indirect hernias. Details of the surgical procedure; Recurrence rate and complication rate of the procedure; Effectiveness of the technique.

  • Incisional hernia: repair retrospective comparison of laparoscopic and open techniques. Bencini, L.; Sanchez, L. J.; Boffi, B.; Farsi, M.; Scatizzi, M.; Moretti, R. // Surgical Endoscopy;Oct2003, Vol. 17 Issue 10, p1546 

    Purpose: A retrospective clinical trial was conducted to compare laparoscopic incisional hernia repair (LIHR) and open traditional repair (OR). Demographics, perioperative data, results, and follow-up data were examined to determine whether there was any difference in outcome,...

  • Metal endoclips for the closure of the appendiceal stump in laparoscopic appendectomy. Alis, H.; Gonenc, M.; Deniztas, C.; Kapan, S.; Turhan, A. // Techniques in Coloproctology;Apr2012, Vol. 16 Issue 2, p139 

    Closure of the appendiceal stump in laparoscopic appendectomy is the most crucial part of the procedure. In this retrospective clinical study, we describe a technique for laparoscopic appendectomy, in which the appendiceal stump is secured by metal endoclips. Medical data of the patients who...

  • Reversal of Hartmann’s procedure through the stomal side: a new even more minimal invasive technique. Vermeulen, Jefrey; Vrijland, Wietske; Mannaerts, Guido H.H. // Surgical Endoscopy;Oct2008, Vol. 22 Issue 10, p2319 

    Several minimal invasive, mainly laparoscopic-assisted, techniques for reversal of Hartmann’s procedure (HP) have been published. The purpose of this pilot study was to assess a minimal invasive procedure through the stomal site that may compare favorably with open or...

  • Laparoscopic appendicectomy reduces complication rate.  // Nursing Standard;2/11/2004, Vol. 18 Issue 22, p10 

    Focuses on the research paper "Laparoscopic Versus Open Appendicectomy: Outcomes Comparison Based on a Large Administrative Database," by U. Gullder, published in the 2004 issue of the periodical "Annals of Surgery." Advantages of laparoscopic appendicectomy over open procedures; Median hospital...

  • Laparoscopic hysterectomy may be better with the robot.  // Contemporary OB/GYN;Apr2012, Vol. 57 Issue 4, p16 

    The article discusses a meta-analysis in Italy that evaluated differences between traditional and robot-assisted laparoscopic hysterectomy and concluded that robotic approach was superior in terms of shorter length of hospital stay, fewer complications, and fewer conversions to laparotomy.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics