Incidence of incisional hernias following single-incision versus traditional laparoscopic surgery: a meta-analysis
To compare, using a meta-analysis of randomized controlled trials, the risk of incisional hernia in patients undergoing single-incision laparoscopic surgery to those undergoing traditional laparoscopic surgery.
MEDLINE and EMBASE databases were searched. Randomized controlled trials comparing single-incision laparoscopic surgery to traditional laparoscopic surgery and which reported incisional hernias over a minimum 6-month follow-up period were eligible. Risk of bias was assessed as outlined in the Cochrane Handbook. Pooled odds ratios were calculated using RevMan.
Of 309 identified studies, 22 were included in this meta-analysis. Pooled results showed higher odds of incisional hernia following single-incision laparoscopic surgery relative to traditional laparoscopic surgery (odds ratio 2.83, 95% CI 1.34–5.98, p = 0.006, I2 = 0%). There was no difference in the odds of incisional hernias requiring surgical repair (p = 0.10). Subgroup analysis found no difference in the odds of incisional hernias based on procedure type (p = 0.69) or method of follow-up (p = 0.85). The quality of evidence was determined to be moderate.
Single-incision laparoscopic surgery is associated with a threefold increase in the odds of incisional hernia compared with traditional laparoscopic surgery.
KeywordsIncisional hernia Single-incision laparoscopic surgery SILS Meta-analysis
The authors thank Paola Durando, M.L.S., from Queen’s University Library, for her assistance in designing the search strategy and performing the search.
MBC and SVP designed the study. All authors were involved in data acquisition and analysis, and in the preparation of the manuscript.
Financial support of this project was provided by The John Franklin Kidd Studentship.
Compliance with ethical standards
Conflict of interest
M.B.C., R.S., and S.V.P. have no conflicts of interest to declare.
This article did not require ethical approval.
Human and animal rights
This article does not contain any studies with human participants or animals performed by any of the authors.
For this type of study, formal consent is not required.
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