Meta‑analysis of single-incision laparoscopic versus multi-trocar laparoscopic totally extraperitoneal inguinal hernia repair

• Published in: Updates in surgery Vol. 75; no. 8; pp. 2133 - 2145
• Main Authors: Wang, Deng-Chao, Fu, Jun-Wen, Jiang, Tao, Chen, Wen-Xing, Yu, Miao
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.12.2023
• Subjects: 2022110085; INPLASY2022110085; Medicine; Medicine & Public Health; Review Article; Surgery; Single-incision; Laparoscopic; Inguinal hernia; Meta-analysis
• ISSN: 2038-131X; 2038-3312
• DOI: 10.1007/s13304-023-01634-0

Whether single-incision laparoscopic totally extraperitoneal (SIL-TEP) inguinal hernia repair is similar or superior to multi-trocar laparoscopic totally extraperitoneal (MTL-TEP) inguinal hernia repair is controversial. We conducted this meta-analysis to compare the safety, efficacy and cosmetic effect of the two surgical methods. We systematically searched the Cochrane Library, Embase database and PubMed database for published studies on SIL-TEP and MTL-TEP inguinal hernia repair. The studies were screened and evaluated for quality according to the inclusion and exclusion criteria, and RevMan 5.3 software was used for meta-analysis. Twenty studies were included, including 7 randomized controlled studies and 13 nonrandomized controlled studies. Meta-analysis revealed no significant difference between SIL-TEP and MTL-TEP inguinal hernia repair in terms of unilateral operation time ( P  = 0.12), bilateral operation time ( P  = 0.72), pain score on the first day after operation ( P  = 0.61], chronic pain rate ( P  = 0.61), total complication rate ( P  = 0.26), hospital stay ( P  = 0.72), and recurrence rate ( P  = 0.83), but the cosmetic effect score ( P  = 0.002) was higher in the former. These findings demonstrate that SIL-TEP inguinal hernia repair is safe, reliable and feasible. In addition, it can result in a better cosmetic effect of the incision than MTL-TEP inguinal hernia repair. SIL-TEP inguinal hernia repair should be considered for patients with stricter cosmetic requirements. Clinical trial registration : INPLASY2022110085.