Laparoscopic ventral hernia repair: a systematic review.

Area of Science:

• General Surgery
• Minimally Invasive Surgery
• Hernia Repair

Background:

• Open mesh repair for ventral hernias involves large incisions, potentially leading to increased pain and longer hospital stays.
• Laparoscopic ventral hernia repair presents an alternative, avoiding large abdominal incisions.

Purpose of the Study:

• To assess the safety and efficacy of laparoscopic ventral hernia repair compared to open ventral hernia repair.
• To evaluate recurrence rates, hospital stay duration, and complication profiles of both surgical approaches.

Main Methods:

• A systematic review was conducted.
• Included six randomized controlled trials (RCTs) and eight nonrandomized comparative studies.

Main Results:

• The laparoscopic approach may demonstrate a lower recurrence rate and shorter hospital stay compared to the open approach.
• Conversion rates to open surgery in RCTs were 0%, while nonrandomized studies reported 0% to 14%.
• Complications for the open approach were primarily wound-related, whereas the laparoscopic approach reported fewer wound- and procedure-related complications.

Conclusions:

• The relative safety and efficacy of laparoscopic versus open ventral hernia repair remain uncertain based on current evidence.
• Laparoscopic repair may be better suited for straightforward hernias, with open repair reserved for complex cases.
• Laparoscopic ventral hernia repair is an acceptable alternative for surgeons skilled in advanced laparoscopic techniques.