SynthesisSurgical endoscopy2023
Learning curve of laparoscopic inguinal hernia repair: systematic review, meta-analysis, and meta-regression.
Synthesis in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
What it found
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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.
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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.
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Who cites it
22 citing papers in PubMed, 32 citations in OpenAlex.
- A learning curve analysis of resident-performed laparoscopic transabdominal preperitoneal inguinal hernia repair and the impact of the operative interval.Surgery today · 2026Article
- Laparoscopic totally extraperitoneal (TEP) versus transabdominal preperitoneal (TAPP) techniques in bilateral inguinal hernia repair: a systematic review and meta-analysis.Surgical endoscopy · 2026Article
- Assessing the learning curve in laparoscopic TAPP repair for emergency inguinal hernia: a comparative study with open repair.Scientific reports · 2026Article
- Association between umbilicus-symphysis pubis distance and operative time in transabdominal preperitoneal (TAPP) inguinal hernia repair.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Laparoscopic vs. open inguinal hernia repair in Central Asia: a systematic review of technological readiness and safety frameworks.Frontiers in surgery · 2026Review
- Comparative study of free vas deferens separation for repair of inguinal hernia and transabdominal preperitoneal prosthesis for adult males.BMC surgery · 2025Article
- Article
- Comparison of modified tumescent and conventional laparoscopic transabdominal pre-peritoneal repair in the patients of inguinal hernia: A randomised control trial.Journal of minimal access surgery · 2025Article
- Short-term outcomes of puncturing forceps-assisted laparoscopic totally extraperitoneal hernioplasty for indirect inguinal hernia: a prospective randomized study.Updates in surgery · 2025Article
- Modern Perspectives on Inguinal Hernia Repair: A Narrative Review on Surgical Techniques, Mesh Selection and Fixation Strategies.Journal of clinical medicine · 2025Review
- Safe implementation of laparoscopic transabdominal preperitoneal repair for groin hernias by surgical residents in Japan: a single-center retrospective study.Surgical endoscopy · 2025Article
- Bilateral Inguinal Hernia Repair: Laparoscopic Totally Extraperitoneal Versus Open Lichtenstein.Acta medica Lituanica · 2025Article
- Impacts of sufentanil/remifentanil plus sevoflurane versus propofol in adults undergoing laparoscopic herniorrhaphy.American journal of translational research · 2025Article
- Ergonomic differences in mesh placement and mesh fixation between laparoscopic and robotic inguinal hernia repair with mesh.Hernia : the journal of hernias and abdominal wall surgery · 2024Article
- Global access to technologies to support safe and effective inguinal hernia surgery: prospective, international cohort study.The British journal of surgery · 2024Article
- A retrospective noninferiority study of laparoscopic inguinal hernia repair feasibility for recently graduated surgeons in Thailand.Journal of minimally invasive surgery · 2024Article
- Glued suture-less peritoneum closure in laparoscopic inguinal hernia repair reduces acute postoperative pain.Scientific reports · 2024Article
- TEP or TAPP: who, when, and how?Frontiers in surgery · 2024Review
- Differences in the learning curve of robotic transabdominal preperitoneal inguinal hernia repair according to surgeon's robotic experience.Hernia : the journal of hernias and abdominal wall surgery · 2023Article
- Bilateral inguinal hernia repair by laparoscopic totally extraperitoneal (TEP) vs. laparoscopic transabdominal preperitoneal (TAPP).BMC surgery · 2023Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLaparoscopic inguinal hernia repair has a long learning curve. It can be a technically challenging procedure and initially presents an unfamiliar view of inguinal anatomy. The aim of this review was to evaluate published literature relating to the learning curve of laparoscopic inguinal hernia repair and identify the number of cases required for proficiency. The secondary aim was to compare outcomes between surgeons before and after this learning curve threshold had been attained.
methodsA systematic literature search was conducted in databases of PubMed, Medline, Embase, Web of Science, and Cochrane Library, to identify studies that evaluated the learning curve of laparoscopic inguinal hernia repair. A meta-regression analysis was undertaken to identify the number of cases to achieve surgical proficiency, and a meta-analysis was performed to compare outcomes between cases that were undertaken during a surgeon's learning phase and experienced phase of the curve.
resultsTwenty-two studies were included in this review, with 19 studies included in the meta-regression analysis, and 11 studies included in the meta-analysis. Mixed-effects Poisson regression demonstrated that there was a non-linear trend in the number of cases required to achieve surgical proficiency, with a 2.7% year-on-year decrease. The predicted number of cases to achieve surgical proficiency in 2020 was 32.5 (p < 0.01). The meta-analysis determined that surgeons in their learning phase may experience a higher rate of conversions to open (OR 4.43, 95% CI 1.65, 11.88), postoperative complications (OR 1.61, 95% CI 1.07, 2.42), and recurrences (OR 1.32, 95% CI 0.40, 4.30).
conclusionLaparoscopic inguinal hernia repair has a well-defined learning curve. While learning surgeons demonstrated reasonable outcomes, supervision during this period may be appropriate given the increased risk of conversion to open surgery. These data may benefit learning surgeons in the skill development of minimally invasive inguinal hernia repairs.
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Registered trials
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.