Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2008 Oct;22(10):2251-60.
doi: 10.1007/s00464-008-9773-7. Epub 2008 Mar 5.

Open versus laparoscopic incisional hernia repair: something different from a meta-analysis

Affiliations
Review

Open versus laparoscopic incisional hernia repair: something different from a meta-analysis

Matthias Kapischke et al. Surg Endosc. 2008 Oct.

Abstract

Background: Incisional hernias after laparotomy are a large financial burden for society as well as for the patients suffering from pain and limitations of activity over time. The introduction of alloplastic materials such as polypropylene seems to improve the results. The question of whether to apply open or laparoscopic implantation of the mesh is of ongoing interest. We compare the available alloplastic materials and try to clarify the question of whether the laparoscopic procedure is superior to the conventional (open) technique based on the available randomized studies.

Methods: All available meshes for intraperitoneal and extraperitoneal implantation were described regarding their handling and their pros and cons. A database search (PubMed, Medline, Ovid, and in the secondary literature) was carried out to retrieve all randomized studies comparing laparoscopic and open hernia repair. Data were reviewed by two independent scientists for surgical and statistical design.

Results: The ideal mesh for a laparoscopic maintenance of abdominal wall hernias as well as the optimal fixation of the mesh has not been found yet. Recent available literature shows no evidence demonstrating the superiority of one of these meshes. The available studies found a lower infection rate, but higher occurrence of seroma for the laparoscopic procedure. The value of the different studies is reduced due to deficiency in study design and power. Guidelines for further studies are discussed to avoid surgical and statistical pitfalls.

Conclusions: Laparoscopic incisional hernia repair shows, in some (randomized) studies as well as a large number of retrospective analyses and in case control studies, superiority compared to conventional hernia repair. Long-term results with a high level of evidence are not available. Additional well-designed randomized trials including long-term observation of patients are required in order to clarify a number of interesting questions.

PubMed Disclaimer

Similar articles

Cited by

References

    1. World J Surg. 2005 Aug;29(8):1066-72 - PubMed
    1. J Biomed Mater Res. 1994 Mar;28(3):373-5 - PubMed
    1. Am Surg. 2006 Sep;72(9):808-13; discussion 813-4 - PubMed
    1. Surg Endosc. 2003 Oct;17(10):1546-51 - PubMed
    1. Surg Endosc. 2007 Mar;21(3):409-13 - PubMed

Substances

LinkOut - more resources