Meta-analysis of laparoscopic groin hernia repair with or without mesh fixation

Eltair, Mokhtar; Hajibandeh, Shahin; Hajibandeh, Shahab; Balakrishnan, Sankar; Alyamani, Ahmad; Radoi, Daniel; Goh, Yan Li; Hanif, M; Kumar, Yogesh; Mobarak, Dham

doi:10.1016/j.ijsu.2019.10.004

Cited by 13 publications

(26 citation statements)

References 17 publications

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“…For OHR, six 18–23 SRMAs compared glue to sutures, eight 10–17 compared SGM to sutures, and one 44 compared non-suture techniques (any glue or SGM) to sutures. For LHR, seven 24–26 , 45–48 and six SRMAs 27–30 , 49 , 50 compared glue versus tack and no fixation versus tack respectively. Two SRMAs 42 , 43 were NMAs.…”

Section: Resultsmentioning

confidence: 99%

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Mesh-fixation technique for inguinal hernia repair: umbrella review

et al. 2022

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Background Mesh-based repair is the standard of surgical care for symptomatic inguinal hernias. Many systematic reviews and meta-analyses (SRMAs) addressed various aspects of these procedures. This umbrella review aimed to report the evidence from all previous SRMAs for open and laparoscopic inguinal hernia repair. Methods SRMAs were identified from MEDLINE, Scopus, Cochrane, Embase, DARE, PROSPERO, CINAHL, JBISRIS, EPPI-Centre, Wiley Online Library and ScienceDirect database according to PRISMA guidelines. Data including mesh-fixation techniques and surgical approach were extracted from selected SRMAs. The corrected covered area was calculated to address study overlap across reviews, and an excess significance test was used to assess potential bias. The outcomes of interest were hernia recurrence, chronic groin pain, operating time, postoperative pain, duration of hospital stay, return to daily life activities, and postoperative complication. Results Thirty SRMAs were included between 2010 and 2019: 16 focused on open repair, and 14 focused on laparoscopic repair, with a high degree of overlap (open repairs, 41 per cent; laparoscopic repairs, 30–57 per cent). Sufficient evidence was available on hernia recurrence, chronic groin pain, and operative time. Effects of glue on hernia recurrence were inconclusive in open and laparoscopy approaches, P = 0.816 and 0.946 respectively. Glue was significantly associated with lower persistent groin pain, in open repair (versus suture) and in laparoscopic repair (versus tack). SRMAs suggested that self-gripping mesh was associated with shorter operating time in open surgery, although with only a few minutes of improvement (0.36–7.85 min, P < 0.001). Conclusion In this umbrella review, chronic groin pain and operating time were the only outcomes for which there was sufficient evidence supporting the effectiveness respectively of glue and self-gripping mesh.

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Section: Resultsmentioning

confidence: 99%

“…Seven SRMAs 27–30 , 43 , 49 , 50 compared no fixation to tack, and eight SRMAs 24–26 , 43 , 46–48 compared glue with tack. The pooled data demonstrated a hernia recurrence rate for suture of 1.93–2.68 per cent in OHR and 2.36 per cent for tacker in LHR.…”

Section: Resultsmentioning

confidence: 99%

Mesh-fixation technique for inguinal hernia repair: umbrella review

et al. 2022

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“…El uso de malla y las indicaciones precisas para la reparación de malla y sin malla se debaten sin un consenso claro. Cuatro ensayos aleatorios prospectivos han evaluado el uso de malla para hernias umbilicales; tres de cuatro informaron tasas de recurrencia más bajas con el uso de mallas, con el mayor beneficio en pacientes con cirrosis y pacientes sometidos a reparación emergente de hernias encarceladas (4,5,6). Un estudio basado en la población danesa informó hallazgos similares.…”

Section: Resultsunclassified

“…Al igual que en otras reparaciones de hernia ventral, la malla se puede colocar como una subcapa (una posición intraabdominal, preperitoneal o retrorectus), una incrustación (tapón de malla suturado a los bordes fasciales) o una incrustación (malla colocada sobre la fascia principalmente cerrada). Al igual que con las reparaciones de malla para hernias ventrales en general, no hay consenso sobre la ubicación ideal para la colocación de malla, y esto debe basarse en el escenario clínico (4,6). El conocimiento de las posibles ventajas y desventajas de los diferentes productos de malla y ubicaciones de malla es esencial.…”

Section: Resultsunclassified

Reparación de hernia umbilical, análisis general del tratamiento quirúrgico

García¹,

Matute

Toral

et al. 2020

jah

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Actualmente no existe consenso sobre la mejor técnica para la reparación de la hernia umbilical en adultos. El papel de la hernioplastia laparoscópica de la hernia umbilical sigue siendo controvertido. Se utilizó un repositorio digital como Pubmed para la búsqueda avanzada de la bibliografía sobre el tema, usando las palabras clave específicas. Se analizaron artículos con menos de diez años de publicación que resultaron de la búsqueda avanzada de la información. Conclusión: Esta revisión de la literatura aclara algunos aspectos del tratamiento quirúrgico de la hernia umbilical: el tipo de procedimiento debe estar determinado por los requisitos de la situación clínica. La reparación laparoscópica se asocia con un menor riesgo de infección, dehiscencia de la herida, recurrencia, estadía más corta pero mayor tiempo operatorio. Las técnicas abiertas se usan con mayor frecuencia debido al pequeño tamaño de estas hernias. Las reparaciones con malla disminuyen las tasas de recurrencia. Las reparaciones laparoscópicas generalmente son adecuadas para pacientes obesos o pacientes con alto riesgo de complicaciones de la herida. Se necesitan más estudios con tecnología robótica para aclarar su beneficio.

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“…We found that laparoscopic surgery required higher medical costs than laparotomy, which is undoubtedly related to the use of surgical equipment and patch materials (total effect = 0.291). The costs of laparoscopic surgery can be significantly reduced if minimal use of disposable instruments and avoidance of preperitoneal balloon and tacker for mesh fixation [42] . There have been many studies comparing hospitalization costs as part of prospective data collection, and the results show the risk of higher costs associated with laparoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

Research on hospitalization costs of inguinal hernia surgery performed at county-level public hospitals in Anhui, China: Insights into Influencing Factors

Wang

Chen

Shen

et al. 2021

Preprint

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Background: Lancet gave a 99-point high score to the comprehensive level of diagnosis and treatment of inguinal hernia in China, and more than half of the inguinal hernia surgery procedures were completed in primary hospitals. At present, the hospitalization costs of inguinal hernia surgery patients in primary hospitals, the influencing factors, and the path between the factors are unclear. Innovative methods are needed to quantify the research and evaluation of hospitalization costs for inguinal hernia surgery patients to emphasise the impact of relevant measures on surgeons and hospital cost-control mechanisms. Methods: A retrospective method was used to collect data from inguinal hernia surgery patients. The relationships between hospitalization costs and the following factors (age, gender, surgery, surgical method, surgical time, preoperative bed stay, postoperative bed stay, length of stay, and surgical costs) were analyzed using Spearman’s correlation analyzes, and how these factors influenced hospital expenditure was explored through structural equation modelling. Results: According to Spearman’s rank correlation analysis, the hospitalization costs were related to the eight selected indicators (rs = -0.084 - 0.549, p < 0.01), and the surgical time was most relevant. The total effect of the surgical time on the hospitalization costs (total effect = 0.459) ranked first in the structural equation model, which means that the risk of hospitalization costs was higher with a longer surgical time.The choice of surgical method had a direct effect on the hospitalization costs (total effect = 0.291), and the effect was second only to the surgical time. Other research factors also had an indirect or direct impact on the hospitalization costs. Conclusion: It is necessary to understand the hospitalization costs of inguinal hernia surgery patients and their influencing factors and interactions to form a scientific price incentive system and cost-control mechanism.

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Meta-analysis of laparoscopic groin hernia repair with or without mesh fixation

Cited by 13 publications

References 17 publications

Mesh-fixation technique for inguinal hernia repair: umbrella review

Mesh-fixation technique for inguinal hernia repair: umbrella review

Reparación de hernia umbilical, análisis general del tratamiento quirúrgico

Research on hospitalization costs of inguinal hernia surgery performed at county-level public hospitals in Anhui, China: Insights into Influencing Factors

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