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Incidence of incisional hernias following single-incision versus traditional laparoscopic surgery: a meta-analysis

  • M. B. Connell
  • R. Selvam
  • S. V. PatelEmail author
Original Article



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.


Incisional 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.

Author contributions

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.

Ethics approval

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.

Informed consent

For this type of study, formal consent is not required.

Supplementary material

10029_2018_1853_MOESM1_ESM.docx (377 kb)
Supplemental Figure 1. MEDLINE search strategy (DOCX 376 KB)
10029_2018_1853_MOESM2_ESM.docx (399 kb)
Supplemental Figure 2. EMBASE search strategy (DOCX 398 KB)


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of MedicineQueen’s UniversityKingstonCanada
  2. 2.General SurgeryKingston Health Sciences CentreKingstonCanada

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