Evidence map›Paper›PMID 40304805›Full record

SynthesisHernia : the journal of hernias and abdominal wall surgery2025

Incisional hernia incidence following laparoscopic versus open abdominal surgery: an updated systematic review and meta-analysis of randomized controlled trials.

Victor Perim, Raquel Nogueira, João P G Kasakewitch, Carlos A Balthazar da Silveira, Diana Q Nguyen, Diego Laurentino Lima, Leandro Totti Cavazzola, Flavio Malcher

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Publisher
In one paragraph

Synthesis in Hernia : the journal of hernias and abdominal wall surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. 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.

Victor PerimDepartment of Surgery, University of Alabama at Birmingham, 1720 2 Nd Avenue S, Birmingham, AL, 35209, USA.
Raquel NogueiraDepartment of Surgery, Montefiore Medical Center, 1825 Eastchester Rd, Bronx, NY, 10461, USA.
João P G KasakewitchDepartment of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA.
Carlos A Balthazar da SilveiraBahiana School of Medicine and Public Health, Dom João VI Avenue, 275, Brotas, BA, 40290-000, Brazil.
Diana Q NguyenDepartment of Surgery, Mount Sinai South Nassau, New York, NY, USA.
Diego Laurentino LimaDepartment of Surgery, Montefiore Medical Center, 1825 Eastchester Rd, Bronx, NY, 10461, USA. dilaurentino@gmail.com.ORCID 0000-0001-7383-1284
Leandro Totti CavazzolaDepartment of Surgery, Federal University of Rio Grande Do Sul, Porto Alegre, Brazil.
Flavio MalcherSystem Chief, Abdominal Core Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIncisional hernias (IH) are a frequent complication following open surgery (OP). While laparoscopic (LAP) surgery is designed to enhance patient recovery through smaller incisions, contemporary quantitative evidence supporting its efficacy in reducing IH rates (IHR) is sparse. This study aims to provide an overview of IHR following OP and LAP abdominal operations.

methodsWe searched for randomized controlled trials (RCTs) studies in PubMed, Cochrane, and Embase from inception until May 2024 comparing OP approach to LAP and reported IH incidence as a postoperative complication. Exclusion criteria included studies involving patients aged ≤ 18 years, those lacking a control group, or those with a follow-up period of less than 12 months. Studies were stratified by procedure type and by fully laparoscopic (T-LAP) versus laparoscopic-assisted (LAP-A) approaches. Statistical analyses were performed using RStudio software. To address potential clinical and methodological heterogeneity across studies, we applied the restricted maximum-likelihood estimator and random-effects models for outcome analysis.

results8.754 studies were screened, and 72 studies were reviewed. From the initial screening, 28 studies involving 6,113 patients were included, of which 3,337 (54.6%) underwent LAP. Analysis revealed a significantly lower incidence of IH among patients who received LAP (RR 0.51; 95% CI 0.33-0.79). Subgroup analysis by surgery type indicated that bariatric (RR 0.20; 95% CI 0.068-0.578) and fundoplication procedures (RR 0.1; 95%CI 0.018-0.545) were associated with a substantial reduction in IHR. Moreover, totally-laparoscopic (T-LAP) procedures showed a significant reduction in IHR (RR 0.26;95%CI 0.14-0.5), while LAP-A procedures failed to show the same benefit.

conclusionLAP surgery is associated with reduced IHR in abdominal operations, with the benefit being particularly notable amongst LAP-A, bariatric, and fundoplication procedures. These findings underscore the advantages of LAP in specific surgical contexts, emphasizing its potential to minimize postoperative complications such as IH. Further research focusing on comparing IHR on open versus LAP approaches is warranted. STUDY REGISTRATION: A review protocol for this systematic review and meta-analysis was registered at PROSPERO (CRD42024551280).

Indexed as

AbdomenIncisional HerniaLaparoscopyPostoperative ComplicationsHumansIncidenceRandomized Controlled Trials as Topic“incisional abdominal wall hernias”“laparoscopic surgery”“open surgery”“robotic surgery”

Identifiers

PMID40304805

What OpenQuestion holds

Textmetadata
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Registered trials

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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.