Recurrence risks in randomized trials of laparoscopic versus open inguinal hernia repair: to pool or not to pool (this is not the question)

Abstract

Because of the diversity in the size of effect, it is doubtful whether data from the available hernia trials should be compiled into a single summary measure. Efficacy estimates in hernia surgery are susceptible to technical issues, which need further scientific appraisal on a larger scale.

Analysis of the SAGES Outcomes Initiative groin hernia database

“…Comparisons of subgroups within the SAGES database need to be performed with caution due to the methodologic issues previously acknowledged. Nevertheless, the data for open mesh and laparoscopic repairs are consistent with data from randomized, controlled trials [3,6,7,13,20,22].…”

Bilateral inguinal hernia after axillary‐femoral artery bypass effectively treated with laparoscopic repair: A case report

“…In TAPP, ample dissection of the myopectineal orifice and placing a mesh that is large enough are extremely important. In particular, in cases with a large hernial orifice—as in the present case—a mesh measuring about 10 × 15 cm should be placed . Combined use of tumescent anesthesia also reduces blood loss during preperitoneal space dissection and allows for expansion of the dissection range.…”

Complications and Recurrences after Different Types of Hernia Repair: How to Deal with It ?

“…We know that a laparoscopic approach needs a longer learning curve compared, for example, to the Lichtenstein technique and that training procedures performed before patient enrollment and large minimal access experience reduce the risk for recur rence in case of laparoscopic approach (1,(4)(5)(6)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24).…”

“…Mesh containing less non-absorbable material will appear and will lead to less foreign body reaction and inflammatory response (5). Table VI gives a synthesis of literature data and the results of hernia repair (1,10,12,13,16,22).…”