Evidence map›Paper›PMID 39419843›Full record

SynthesisSurgical endoscopy2025

Single-port versus multi-port laparoscopic and robotic inguinal hernia repair: a systematic review and network meta-analysis.

Theethawat Thanawiboonchai, Amanda Cyntia Lima Fonseca Rodrigues, Alba Zevallos, Fatemeh Shojaeian, Brett Colton Parker, Alisa Mae Coker, Hao Deng, Gina Lynn Adrales

Abstract readSystematic ReviewComparative StudyNetwork Meta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Review
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

8 authors.

Theethawat ThanawiboonchaiDivision of Minimally Invasive Surgery, Department of Surgery, The Johns Hopkins School of Medicine, Baltimore, MD, USA.ORCID 0009-0001-7571-8266
Amanda Cyntia Lima Fonseca RodriguesDepartment of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Alba ZevallosDepartment of Surgery, Northwest Hospital, Randallstown, MD, USA.
Fatemeh ShojaeianDivision of Minimally Invasive Surgery, Department of Surgery, The Johns Hopkins School of Medicine, Baltimore, MD, USA.
Brett Colton ParkerDivision of Minimally Invasive Surgery, Department of Surgery, The Johns Hopkins School of Medicine, Baltimore, MD, USA.
Alisa Mae CokerDivision of Minimally Invasive Surgery, Department of Surgery, The Johns Hopkins School of Medicine, Baltimore, MD, USA.
Hao DengDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and, Harvard Medical School, Boston, MA, USA.
Gina Lynn AdralesDivision of Minimally Invasive Surgery, Department of Surgery, The Johns Hopkins School of Medicine, Baltimore, MD, USA. gadrale1@jhmi.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe evolution of minimally invasive surgery has transformed inguinal hernia repair (IHR). The innovative single-port technique reduces the number of surgical incisions. However, the benefits of single-port IHR remain controversial. Our systematic review and network meta-analysis assess the efficacy and clinical outcomes of single-port laparoscopic inguinal hernia repair (SPL-IHR), multi-port laparoscopic inguinal hernia repair (MPL-IHR), single-port robotic inguinal hernia repair (SPR-IHR), and multi-port robotic inguinal hernia repair (MPR-IHR).

methodsA comprehensive search was conducted in PubMed, EMBASE, Cochrane, and Ovid for articles published before January 2024, focusing on complication rates, recurrence, seroma, hematoma, operative time, post-operative pain, and cosmetic outcomes of laparoscopic or robotic IHR. Both extraperitoneal (TEP) and transabdominal (TAPP) approaches were analyzed using MetaInsight. MPL-TAPP was used as the standard for comparison.

resultsThirty-seven studies, including 5,038 patients, 36.92% (1,860 patients) underwent MPL-TEP, 23.64% (1,191 patients) SPL-TEP, 22.23% (1,120 patients) MPR-TAPP, 10.08% (508 patients) MPL-TAPP, 5.40% (272 patients) SPL-TAPP, and 1.73% (87 patients) SPR-TAPP. There were no significant differences in the rates of post-operative complications, hernia recurrence, hematoma, or seroma among the techniques when compared to MPL-TAPP. For secondary outcomes, MPR-TAPP significantly increased the operative time for unilateral hernia repair by a mean difference (MD) of 10.60 min [95% CI: 2.16-19.04]. Conversely, for bilateral hernia repair, there was no significant difference. Post-operative pain was significantly higher for MPL-TEP and SPL-TEP, with MDs of 1.44 [95% CI: 0.43 to 2.44] and 1.22 [95% CI: 0.18 to 2.26], respectively. SPL-TEP was significantly favored in cosmetic outcomes over MPL-TEP, with an MD of 0.65 [95% CI: 0.07 to 1.24].

conclusionIn our network meta-analysis, the risk of post-operative complications, including recurrence, hematoma, and seroma, does not significantly vary among single-port and multi-port laparoscopic or robotic techniques. This suggests that surgical technique selection can rely on surgeon expertise and resource availability, without compromising outcomes.

Indexed as

Hernia, InguinalHerniorrhaphyLaparoscopyRobotic Surgical ProceduresHumansOperative TimePostoperative ComplicationsPostoperative PainRecurrenceTreatment OutcomeInguinal hernia repairRobotic inguinal hernia repairSingle incision surgerySingle port surgeryTotally Extra Peritoneal (TEP)Trans-Abdominal PrePeritoneal (TAPP)

Identifiers

PMID39419843

What OpenQuestion holds

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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.