Laparoscopic versus open hernia repair: a meta-analysis of post operative pain, recurrence rate and return to activity
DOI:
https://doi.org/10.18203/2349-2902.isj20261997Keywords:
Laparoscopic hernia repair, Open hernia repair, Postoperative pain, Recurrence, Return to activity, Meta-analysisAbstract
Herniorrhaphy is among the most commonly performed surgical procedures worldwide. Open and laparoscopic techniques remain the principal approaches, but the long-term comparative benefits of laparoscopy are debated. This systematic review and meta-analysis evaluated outcomes of laparoscopic versus open hernia repair. A systematic search of PubMed and DOAJ (2010-2025) was conducted in line with PRISMA guidelines. Eligible studies included patients ≥12 years undergoing elective inguinal or incisional hernia repair. Primary outcomes were postoperative pain (acute and chronic), recurrence, and time to return to normal activity/work. Data were pooled using review manager 5.4 with a random-effects model. Risk of bias was assessed with ROB 2.0 for randomized trials and the Newcastle–Ottawa scale for observational studies. Ten studies involving over 8,500 patients were included. Laparoscopic repair was associated with significantly lower early postoperative pain (MD=-1.22, 95% CI-1.67 to -0.78, p<0.001; I²=65%). No significant difference was observed for chronic pain (RR=0.85, 95% CI 0.34-2.14, p=0.74; I²=93.7%). Recurrence rates were comparable between approaches (RR=1.12, 95% CI 0.67-1.86, p=0.66; I²=70.1%). Return to normal activity was earlier with laparoscopy (MD=-5.12 days, 95% CI-7.45 to -2.79, p<0.001). Laparoscopic repair provides advantages in reducing early pain and accelerating recovery, without increasing recurrence risk. Evidence for chronic pain reduction is inconclusive due to study heterogeneity. Further high-quality, multicentre trials with standardized outcomes are needed.
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