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Current status of single-port versus multi-port approach in laparoscopic inguinal hernia mesh repair: an up-to-date systematic review and meta-analysis

  • K. Perivoliotis
  • G. Tzovaras
  • C. Sarakatsianou
  • I. BaloyiannisEmail author


A meta-analysis was conducted to provide an up-to-date comparison of single-port and multi-port approach, in laparoscopic inguinal hernia mesh repair. This meta-analysis was performed on the basis of the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. The electronic databases (MEDLINE, Web of Science and Cochrane Central Register of Controlled Clinical Trials) were systematically screened. Fixed Effects or Random Effects model was used, according to the Cochran Q test. In total 16 eligible studies were found. There was no statistically significant difference, regarding unilateral operation duration, between the two approaches, in TEP (OR − 4.61; 95% CI − 9.70, 0.47, p = 0.08) or TAPP (OR − 1.96; 95% CI − 4.89, 0.97, p = 0.19) procedures. Similarly, in both operative modalities, no superiority of either approach was proven, in terms of conversion rate (TEP OR 0.69, p = 0.48; TAPP OR 5.46, p = 0.31), length of hospital stay (TEP WMD 0.00, p = 0.76; TAPP WMD − 0.11, p = 0.42) and overall complication rate (TEP OR 1.10, p = 0.51; TAPP OR 0.74, p = 0.43). Overall, single-port and the established multi-port approach in inguinal hernia mesh repair, are equivalent, regarding the postoperative outcomes. Given several limitations, further RCTs, of higher methodological and quality level are required.


Laparoscopic inguinal hernia repair Single port Transabdominal preperitoneal (TAPP) repair Total extraperitoneal (TEP) repair 


Compliance with ethical standards

Conflict of interest

KP declares no conflict of interest, GT declares no conflict of interest, CS declares no conflict of interest, IB declares no conflict of interest.

Ethical approval

Approval from the institutional review board was not required for this type of study.

Human and animal rights

This article is a systematic review and meta-analysis and it contains data collected through literature review. It does not include research directly involving human or animal participation.

Informed consent

For this type of study, informed consent was not necessary.

Supplementary material

10029_2018_1876_MOESM1_ESM.pdf (122 kb)
Supplementary material 1 (PDF 121 KB)
10029_2018_1876_MOESM2_ESM.pdf (393 kb)
Supplementary material 2 (PDF 393 KB)


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© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of SurgeryUniversity Hospital of LarissaLarissaGreece
  2. 2.Department of AnesthesiologyUniversity Hospital of LarissaLarissaGreece
  3. 3.Department of SurgeryUniversity Hospital of LarissaLarissaGreece

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