• Philip P Goodney, Christian M Birkmeyer, and John D Birkmeyer.
• VA Outcomes Group, Department of Veteran Affairs Medical Center, White River Junction, VT 05009, USA. philip.goodney@hitchcock.org
• Arch Surg Chicago. 2002 Oct 1; 137 (10): 1161-5.

BackgroundAlthough laparoscopic repair of ventral hernia has become increasingly popular, its outcomes relative to open repair have not been well characterized. For this reason, we performed a meta-analysis of studies comparing open and laparoscopic ventral (including incisional) hernia repair.HypothesisLaparoscopic ventral hernia repair results in better short-term outcomes than open ventral hernia repair.Data SourcesStructured MEDLINE search for published studies. One unpublished study was also identified.Study SelectionStudies were selected on the basis of study design (comparison of laparoscopic and open ventral hernia repair). The 3 main outcome measures were perioperative complications, operative time, and length of hospital stay. Of 83 potential studies identified by abstract review, 8 (10%) met the inclusion criteria.Data ExtractionTwo reviewers assessed each article to determine eligibility for inclusion and, where appropriate, abstracted information on patient characteristics and main outcome measures.Data SynthesisAcross 8 studies, 390 patients underwent open repair and 322 underwent laparoscopic repair. Perioperative complications were less than half as likely to occur in patients undergoing laparoscopic repair (14% vs 27%; P =.03; odds ratio, 0.42; 95% confidence interval, 0.29-0.68). Average length of stay was shorter in the laparoscopic group (2.0 vs 4.0 days; P =.02). No statistically significant difference in operative times was noted between laparoscopic and open repair (99 vs 96 minutes; P =.38).ConclusionsLaparoscopic ventral hernia repair offers lower complication rates and shorter length of stay than open repair. However, randomized controlled trials and studies with long-term follow-up are needed to confirm these findings and to assess long-term rates of hernia recurrence.

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