Incidence of incisional hernias following single-incision versus traditional laparoscopic surgery: a meta-analysis

PurposeTo compare, using a meta-analysis of randomized controlled trials, the risk of incisional hernia in patients undergoing single-incision laparoscopic surgery to those undergoing traditional laparoscopic surgery.MethodsMEDLINE and EMBASE databases were searched. Randomized controlled trials comparing single-incision laparoscopic surgery to traditional laparoscopic surgery and which reported incisional hernias over a minimum 6-month follow-up period were eligible. Risk of bias was assessed as outlined in the Cochrane Handbook. Pooled odds ratios were calculated using RevMan.ResultsOf 309 identified studies, 22 were included in this meta-analysis. Pooled results showed higher odds of incisional hernia following single-incision laparoscopic surgery relative to traditional laparoscopic surgery (odds ratio 2.83, 95% CI 1.34-5.98, p=0.006, I-2=0%). There was no difference in the odds of incisional hernias requiring surgical repair (p=0.10). Subgroup analysis found no difference in the odds of incisional hernias based on procedure type (p=0.69) or method of follow-up (p=0.85). The quality of evidence was determined to be moderate.ConclusionSingle-incision laparoscopic surgery is associated with a threefold increase in the odds of incisional hernia compared with traditional laparoscopic surgery.