Evidence map›Paper›PMID 41063071›Full record

SynthesisBMC surgery2025

Comparative outcomes of synthetic and biological mesh use in laparoscopic inguinal hernia repair: a systematic review and meta-analysis.

Candela Romano, Hugo Silva, Laura A Gray, Carla Ibarra, William Soto, Lorenzo G Fernandez, Jorge Vazquez Del Real, Rafael Pinto-Colmenarez, Victor Sebastian Arruarana, Daniela Fulginiti

Erratum issuedAbstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–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 synthesis or guideline pooled it.

  1. Pooled it
  2. Hernia mesh repair in immunocompromised patients: a comprehensive review.Hernia : the journal of hernias and abdominal wall surgery · 2026
    Review
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Candela RomanoUniversity of California, Irvine, 101 The City Drive South, ZC4482, Orange, CA, 92868, USA. candelr@hs.uci.edu.
Hugo SilvaUniversidad Autónoma de Baja California, Baja California, México.
Laura A GrayUniversidad Autónoma de Guadalajara, Tabasco, México.
Carla IbarraPontificia Universidad Católica del Ecuador, Quito, Ecuador.
William SotoInstituto Tecnológico de Santo Domingo, Santo Domingo, Dominican Republic.
Lorenzo G FernandezUniversidad Nacional de Córdoba, Córdoba, Argentina.
Jorge Vazquez Del RealUniversidad de Guadalajara, Guadalajara, Jalisco, México.
Rafael Pinto-ColmenarezDepartment of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, USA.
Victor Sebastian ArruaranaBrookdale Hospital, New York, NY, USA.
Daniela FulginitiUniversidad Católica de Argentina, Buenos Aires, Argentina.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInguinal hernias occur when abdominal contents protrude through the inguinal canal. Laparoscopic repair is often preferred due to reduced postoperative pain, quicker recovery, and better cosmetic results. While synthetic mesh remains the standard, concerns about complications have prompted interest in biological meshes, which may integrate better with tissue but are more expensive and lack long-term data.

methodsWe conducted a meta-analysis of studies published between 2015 and 2025 that compared biological versus synthetic mesh in laparoscopic inguinal hernia repair among adults. Only randomized controlled trials and cohort studies published in English were included. The primary and secondary outcomes were hernia recurrence and postoperative complications.

resultsOut of 6017 records, three studies involving 1372 participants met the inclusion criteria. All compared porcine small intestinal submucosa (SIS) biological mesh with synthetic mesh. SIS mesh was associated with longer operating times (SMD 0.45; 95% CI: 0.02-0.87; p = 0.039). However, there were not a statistically significant differences in recurrence (RR 12.73; p = 0.15), complications (RR 3.06; p = 0.55), or adverse events (RR 5.38; p = 0.21). Heterogeneity was high, and funnel plots suggested possible publication bias.

conclusionBiological mesh did not show a clear benefit over synthetic mesh in laparoscopic inguinal hernia repair. While it may reduce chronic pain, it requires longer operative time and raises concerns about cost and long-term outcomes. Larger, high-quality studies are needed to clarify their role in clinical practice.

Indexed as

Hernia, InguinalHerniorrhaphyLaparoscopySurgical MeshAnimalsHumansPostoperative ComplicationsRecurrenceTreatment OutcomeBiological meshInguinal herniaLaparoscopicLaparoscopic incisional hernia repairSurgical meshSynthetic mesh

Identifiers

PMID41063071
PMCPMC12505747

What OpenQuestion holds

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LicenceCC BY
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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.