Evidence map›Paper›PMID 34031740›Full record

SynthesisSurgical endoscopy2021

Endoscopic onlay repair for ventral hernia and rectus abdominis diastasis repair: Why so many different names for the same procedure? A qualitative systematic review.

Flavio Malcher, Diego Laurentino Lima, Raquel Nogueira C L Lima, Leandro Totti Cavazzola, Christiano Claus, Caroline T Dong, Prashanth Sreeramoju

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 3 pooled it
5.4field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 40 citations in OpenAlex.

  1. Pooled it
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  9. Principles of rectus diastasis classification and treatment.Hernia : the journal of hernias and abdominal wall surgery · 2025
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 2 countries.

Flavio MalcherDepartment of Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Diego Laurentino LimaDepartment of Surgery, Montefiore Medical Center, 1825 Eastchester Road, The Bronx, NY, 10461, USA. dilaurentino@gmail.com.ORCID 0000-0001-7383-1284
Raquel Nogueira C L LimaPernambuco Health College, Recife, PE, Brazil.
Leandro Totti CavazzolaDepartment of Surgery, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Christiano ClausPositivo University, Curitiba, Brazil.
Caroline T DongDepartment of Surgery, Montefiore Medical Center, Bronx, NY, USA.
Prashanth SreeramojuDepartment of Surgery, Montefiore Medical Center, Bronx, NY, USA.
Montefiore Medical Center · USAlbert Einstein College of Medicine · USUniversidade Federal do Rio Grande do Sul · BRUniversidade Positivo · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA subcutaneous endoscopic onlay repair for ventral hernia with an anterior plication of diastasis recti (DR) has been published under different names in different countries. The aim of this systematic review is to assess the safety and feasibility of different named techniques with the same surgical concept.

methodsThe PRISMA guidelines were followed during all stages of this systematic review. The MINORS score system was used to perform qualitative assessment of all studies included in this review. Recommendations were then summarized for the following pre-defined key items: protocol, research question, search strategy, study eligibility, data extraction, study designs, risk of bias, publication bias, heterogeneity, and statistical analysis.

resultsThe systematic literature search found 2548 articles, 317 of which were duplicates and excluded from analysis. The titles and abstracts from the remaining 2231 articles were assessed. After careful evaluation, 2125 articles were determined to be unrelated to our study and subsequently excluded. The full text of the remaining 106 articles was thoroughly assessed. Case reports, editorials, letters to the editor, and general reviews were then excluded. A total of 13 articles were ultimately included for this review, describing a similar subcutaneous endoscopic approach for repair of concomitant ventral hernias and rectus diastasis defined under nine different named techniques on 716 patients. The number of patients in those studies varied from 10 to 201. The mean operative time varied from 68.5 to 195 min. The most common complication was seroma, followed by pain requiring intervention, hematoma, and surgical site infection.

conclusionsThere are a few technique variations described in different studies, but with no significant differences in outcomes. We, therefore, propose to unify these procedures under one term, ENDoscopic Onlay Repair (ENDOR). This technique has shown to be effective and safe, with seroma being the most common complication.

Indexed as

Diastasis, MuscleHernia, VentralEndoscopyHerniorrhaphyHumansRectus AbdominisSurgical MeshDiastasis rectiEndoscopicHerniasMinimally invasive surgerySurgical procedureVentral

Identifiers

PMID34031740
OpenAlexW3164422152

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.