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Review
. 2023 Aug;75(5):1305-1336.
doi: 10.1007/s13304-023-01534-3. Epub 2023 May 22.

Laparoscopic treatment of ventral hernias: the Italian national guidelines

Fabio Cesare Campanile  1 , Mauro Podda  2 , Francesca Pecchini  3 , Marco Inama  4 , Sarah Molfino  5 , Marco Augusto Bonino  6 , Monica Ortenzi  7 , Gianfranco Silecchia  8 , Ferdinando Agresta  9 , Michela Cinquini  10 ; Italian Laparoscopic Ventral Hernia Guideline Group
Collaborators, Affiliations
Review

Laparoscopic treatment of ventral hernias: the Italian national guidelines

Fabio Cesare Campanile et al. Updates Surg. 2023 Aug.

Abstract

Primary and incisional ventral hernias are significant public health issues for their prevalence, variability of professional practices, and high costs associated with the treatment In 2019, the Board of Directors of the Italian Society for Endoscopic Surgery (SICE) promoted the development of new guidelines on the laparoscopic treatment of ventral hernias, according to the new national regulation. In 2022, the guideline was accepted by the government agency, and it was published, in Italian, on the SNLG website. Here, we report the adopted methodology and the guideline's recommendations, as established in its diffusion policy. This guideline is produced according to the methodology indicated by the SNGL and applying the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) methodology. Fifteen recommendations were produced as a result of 4 PICO questions. The level of recommendation was conditional for 12 of them and conditional to moderate for one. This guideline's strengths include relying on an extensive systematic review of the literature and applying a rigorous GRADE method. It also has several limitations. The literature on the topic is continuously and rapidly evolving; our results are based on findings that need constant re-appraisal. It is focused only on minimally invasive techniques and cannot consider broader issues (e.g., diagnostics, indication for surgery, pre-habilitation).

Keywords: Italian Guidelines; Laparoscopic ventral hernia repair; Minimally invasive ventral hernia repair.

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Conflict of interest statement

The authors report no conflict of interest. This research was funded by the Italian Society of Endoscopic Surgery and New Technologies (Società Italiana di Chirurgia Endoscopica e Nuove Tecnologie—SICE -).

Figures

Fig. 1
Fig. 1
PRISMA Flow-diagram
Fig. 2
Fig. 2
Laparoscopic vs. Open repair: Postoperative morbidity (A), Surgical-Site Infection—general (B), Surgical-Site Infection—low risk of bias (C), Surgical-Site Infection—incisional hernias only (D)
Fig. 3
Fig. 3
Laparoscopic vs. Open repair: Full-thickness enterotomies—general (A), Full-thickness enterotomies—low risk of bias (B), Full-thickness enterotomies—incisional hernias only (C), Seromas (D), Hematomas (E)
Fig. 4
Fig. 4
Laparoscopic vs. Open repair: Re-operations (A), Hernia recurrence (B), Length of hospital stay (C), Post-operative pain (D)
Fig. 5
Fig. 5
Laparoscopic IPOM vs. IPOMplus: Postoperative morbidity—RCTs (A), Postoperative morbidity—Observational studies (B), Seromas—RCTs (C), Seromas—Observational studies (D), Surgical-Site Infections (E)
Fig. 6
Fig. 6
Laparoscopic IPOM vs. IPOMplus: Re-operations—RCTs (A), Re-operations—Observational studies (B), Hernia recurrence—RCTs (C), Hernia recurrence—Observational studies (D)
Fig. 7
Fig. 7
Robotic vs. Laparoscopic repair: Postoperative morbidity (A), Surgical-Site Occurrence (B), Seroma (C), Hospital readmission (D), Re-operation (E), Length of hospital stay (F), Recurrence (G)
See this image and copyright information in PMC

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