Laparoscopic vs. Open Surgery for Hernia Repair: A Meta-Analysis

Abstract

The objective of this meta-analysis is to systematically address the following clinical question: does Laparoscopic surgery provide superior clinical outcome to Open surgery for hernia patients? Hernia repair is one of the most frequent surgical procedures worldwide and the laparoscopic vs open debate has been ongoing for a while. Laparoscopy, being minimally invasive surgery, has possible advantages of lesser post-operative pain, shorter time to recovery, and shorter hospital days. On the other hand, the techniques of this type constitute an open surgery that seems to be superior to the other types especially because of some advantages that come with it like lower incidence of reappearance of some types of hernias.  The quantitative data were extracted from 25 RCTs and observational studies published in two decades, including 10,500 patients in total. Major measure of effectiveness assessed in this meta-analysis is postoperative complications which includes wound infection, hematomas, seromas, hernia recurrence, operative periods, length of hospital stay, and time to resume usual activities. According to the study, minimally invasive surgery leads to better results such as fewer wound infections, shorter lengths of hospital stay, and shorter time to resume normal activities. But the compared analysis of the open surgery has demonstrated lesser recurrence rate by a small margin in case of complicated or big hernias. Also, Laparoscopic procedures are associated with a longer operative time and steep entry to mastery curve amongst surgeons. Nevertheless, laparoscopic hernia repair is as effective as an open procedure with similar long-term outcomes of the surgeries. Therefore, the choice of the specified techniques should be made based on personal factors that include the type and location of hernia and the qualification of the surgeon. Overall, this meta-analysis emphasizes that more research should be conducted regarding the selection criteria for the patient as well as the surgeon to get the greatest benefits from laparoscopic surgery and the volume of laparoscopic urological cancer surgery should be increased.