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Hybrid intraperitoneal onlay mesh repair for incisional hernias: a systematic review and meta-analysis

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Abstract

Introduction

Laparoscopic IPOM is technically challenging, especially regarding fascial closure. Hybrid repair has been proposed as a simpler approach. We aimed to compare hybrid and laparoscopic intraperitoneal onlay mesh repair (IPOM) in patients undergoing ventral hernia repair (VHR).

Methods

We performed a systematic review of Cochrane, Scopus, and MEDLINE databases to identify studies comparing hybrid versus laparoscopic IPOM VHR reporting the outcomes of recurrence, mortality, seroma, postoperative complications, reoperation, surgical site infection, and operative time. Statistical analysis was performed using RStudio 4.1.2 using a random-effects model.

Results

We screened 2,896 articles and fully reviewed 22 of them. A total of five studies, encompassing 664 patients were included. Among them, 337 (50.8%) underwent laparoscopic IPOM. All patients had incisional hernias, with a mean diameter varying from 3 to 12.7 cm, 60% were women, with a mean BMI varying from 29.5 to 38. The hybrid approach had a lower rate of seroma when compared to the laparoscopic (OR 0.22; 95% CI 0.05 to 0.92; p = 0.038; I²=78%). We found no difference in recurrence, mortality, postoperative complications, reoperation, surgical site infection, and operative time between groups.

Conclusion

Hybrid IPOM is a safe and effective method for incisional hernia repair. Moreover, it facilitates fascial defect closure and decreases postoperative seromas.

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Data Availability

All data are available in the included articles.

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Authors and Affiliations

  1. Division of Surgery, Federal University of the Southern Border (Universidade Federal da Fronteira Sul), 20 Capitão Araujo St., Passo, Fundo, 99010-121, Brazil

    Patrícia Marcolin

  2. Division of Surgery, Federal University of Health Sciences of Porto Alegre (Universidade Federal de Ciências da Saúde de), 245 Sarmento Leite St., Porto Alegre, 90050-170, Brazil

    Sarah Bueno Motter, Gabriela. R Brandão & Bruna Oliveira Trindade

  3. Division of Surgery, Montefiore Medical Center, 111 E 210th St., Bronx, NY, 10467, USA

    Diego L. Lima

  4. Division of Surgery, Center for Abdominal Core Health, Cleveland Clinic Foundation, Cleveland, Ohio, 9500 Euclid Ave., 44195, USA

    Sérgio Mazzola Poli de Figueiredo

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Contributions

SMPF conceptualized the study. PM and SBM conducted the literature search and performed data analysis. PM drafted the manuscript, while GRB, DLL, BOT, and SMPF provided critical revisions to the article.SMPF formulated the initial research idea and study objectives. PM and SMPF designed the methodology and statistical analysis plan. PM conducted the data analysis and interpreted the results, with input and validation from SMPF. PM, SBM, and GRB carried out the experimental procedures and collected the primary data, ensuring the accuracy and reliability of the results. Original Draft Preparation: The initial draft of the manuscript was primarily written by PM, with substantial contributions from SMPF and DLL. All authors actively participated in reviewing and editing the manuscript, providing critical feedback and improving its overall quality. All authors have read and approved the final version of the manuscript.

Corresponding authors

Correspondence to Patrícia Marcolin, Sarah Bueno Motter, Gabriela. R Brandão, Diego L. Lima, Bruna Oliveira Trindade or Sérgio Mazzola Poli de Figueiredo.

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PM, SBM, GRB, DLL, BOT, and SMPF declare no conflicts of interest.

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Marcolin, P., Bueno Motter, S., Brandão, G.R. et al. Hybrid intraperitoneal onlay mesh repair for incisional hernias: a systematic review and meta-analysis. Hernia (2024). https://doi.org/10.1007/s10029-024-03105-w

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