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Surgical Endoscopy

, Volume 29, Issue 7, pp 1769–1780 | Cite as

Laparoscopic repair reduces incidence of surgical site infections for all ventral hernias

  • Nestor A. Arita
  • Mylan T. Nguyen
  • Duyen H. Nguyen
  • Rachel L. Berger
  • Debbie F. Lew
  • James T. Suliburk
  • Erik P. Askenasy
  • Lillian S. Kao
  • Mike K. LiangEmail author
Article

Abstract

Background

The role of laparoscopic repair of ventral hernias remains incompletely defined. We hypothesize that laparoscopy, compared to open repair with mesh, decreases surgical site infection (SSI) for all ventral hernia types.

Methods

MEDLINE, EMBASE, and Cochrane databases were reviewed to identify studies evaluating outcomes of laparoscopic versus open repair with mesh of ventral hernias and divided into groups (primary or incisional). Studies with high risk of bias were excluded. Primary outcomes of interest were recurrence and SSI. Fixed effects model was used unless significant heterogeneity, assessed with the Higgins I square (I 2), was encountered.

Results

There were 5 and 15 studies for primary and incisional cohorts. No difference was seen in recurrence between laparoscopic and open repair in the two hernia groups. SSI was more common with open repair in both hernia groups: primary (OR 4.17, 95 %CI [2.03–8.55]) and incisional (OR 5.16, 95 %CI [2.79–9.57]).

Conclusions

Laparoscopic repair, compared to open repair with mesh, decreases rates of SSI in all types of ventral hernias with no difference in recurrence. These data suggest that laparoscopic approach may be the treatment of choice for all types of ventral hernias.

Keywords

Ventral hernia Primary hernia Incisional hernia Laparoscopic repair Meta-analysis 

Notes

Acknowledgments

This work was supported by the Center for Clinical and Translational Sciences, which is funded by the National Institutes of Health Clinical and Translational Award UL1 TR000371 and KL2 TR000370 from the National Center for Advancing Translational Sciences. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources or the National Institutes of Health.

Disclosures

Author Mike Liang discloses a KL2 TR000370 from the National Institutes of Health.

Authors Nestor A. Arita, Mylan T. Nguyen, Duyen H. Nguyen, Rachel L. Berger, Debbie F. Lew, James T. Suliburk, Erik P. Askenasy, and Lillian S. Kao have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Nestor A. Arita
    • 1
  • Mylan T. Nguyen
    • 2
  • Duyen H. Nguyen
    • 2
  • Rachel L. Berger
    • 1
  • Debbie F. Lew
    • 2
  • James T. Suliburk
    • 1
  • Erik P. Askenasy
    • 1
  • Lillian S. Kao
    • 2
  • Mike K. Liang
    • 2
    Email author
  1. 1.Department of General SurgeryBaylor College of MedicineHoustonUSA
  2. 2.Department of General SurgeryUniversity of Texas Health Science Center at HoustonHoustonUSA

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