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

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

Single-incision laparoscopic surgery is associated with a threefold increase in the odds of incisional hernia compared with traditional laparoscopic surgery.

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Acknowledgements

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.

Funding

Financial support of this project was provided by The John Franklin Kidd Studentship.

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Authors and Affiliations

  1. School of Medicine, Queen’s University, Kingston, ON, Canada

    M. B. Connell & R. Selvam

  2. General Surgery, Kingston Health Sciences Centre, 76 Stuart Street, Burr 2, Kingston, ON, K7L 2V7, Canada

    S. V. Patel

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  1. M. B. Connell
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  2. R. Selvam
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Contributions

MBC and SVP designed the study. All authors were involved in data acquisition and analysis, and in the preparation of the manuscript.

Corresponding author

Correspondence to S. V. Patel.

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M.B.C., R.S., and S.V.P. have no conflicts of interest to declare.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Connell, M.B., Selvam, R. & Patel, S.V. Incidence of incisional hernias following single-incision versus traditional laparoscopic surgery: a meta-analysis. Hernia 23, 91–100 (2019). https://doi.org/10.1007/s10029-018-1853-6

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  • DOI: https://doi.org/10.1007/s10029-018-1853-6

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