Meta-analysis of randomized controlled trials comparing open and laparoscopic ventral and incisional hernia repair with mesh

BACKGROUND: Laparoscopic ventral and incisional hernia repair has been reported in a number of small trials to have equivalent or superior outcomes to open repair. METHODS: Randomized controlled trials comparing laparoscopic and open incisional or ventral hernia repair with mesh that included data on effectiveness and safety were included in a meta-analysis. RESULTS: Eight studies met the inclusion criteria. There was no difference between groups in hernia recurrence rates (relative risk 1.02 (95 per cent confidence interval (c.i.) 0.41 to 2.54)). Duration of surgery varied. Mean length of hospital stay was shorter after laparoscopic repair in six of the included studies; the longest mean stay was 5.7 days for laparoscopic and 10 days for open surgery. Laparoscopic hernia repair was associated with fewer wound infections (relative risk 0.22 (95 per cent c.i. 0.09 to 0.54)), and a trend toward fewer haemorrhagic complications and infections requiring mesh removal. CONCLUSION: Laparoscopic repair of ventral and incisional hernia is at least as effective, if not superior to, the open approach in a number of outcomes.