Open versus laparoscopic techniques for incisional hernia repair: A systematic review and meta-analysis of randomized controlled trials
Bibliographic record
Abstract
Background: The choice between open and laparoscopic techniques for incisional hernia repair remains debated in surgical practice. This systematic review and meta-analysis was aimed at comparing the clinical outcomes of open versus laparoscopic incisional hernia repair in adults, with a focus on postoperative complications, recurrence, recovery, and patient satisfaction. Methods: A comprehensive literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized controlled trials (RCTs) comparing open and laparoscopic repair of incisional hernias were included. The main outcomes were postoperative complications (wound infection, hematoma, seroma, ileus, and sepsis), recurrence rates, time to recovery, and quality of life. A total of 726 patients from studies conducted in Europe and the United States were included: 365 in the open surgery group and 361 in the laparoscopic group. Results: The meta-analysis revealed no statistically significant differences between techniques regarding overall postoperative complications, recurrence rates, or quality-of-life scores. Although the rate of wound infection and the incidence of ileus were slightly lower in the laparoscopic group than the open surgery group, the differences were not statistically significant. Additionally, the recurrence rates were comparable between approaches (risk ratio = 1.00, 95 % CI: 0.64-1.57). However, seroma formation exhibited significant heterogeneity across studies. Laparoscopic repair was associated with faster recovery and better long-term quality of life, particularly physical and emotional well-being. Conclusion: This systematic review and meta-analysis demonstrated no significant differences in primary clinical outcomes between open and laparoscopic incisional hernia repair techniques. Both approaches had comparable complication and recurrence rates. However, laparoscopic repair might provide advantages of faster recovery and improved postoperative quality of life, and therefore is a viable alternative to open repair for suitable candidates. Further studies with larger sample sizes and standardized protocols are necessary to confirm these findings.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.020 | 0.047 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.022 | 0.034 |
| Bibliometrics | 0.008 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".