Purpose
There is a controversial premise about choosing a surgical approach in ventral hernia using laparoscopic repair. Some surgeons prefer to use mesh with closure while others prefer to use mesh without closure. This study aims to compare mainly the rate of recurrence in mesh repair with and without closure.
Methods
A wide range of electronic bibliographic databases such as PubMed, Embase, and ERIC was searched. Based on the eligibility criteria, all studies which compared the results after hernia repair from 2010 to 2020, were incorporated. Following screening the abstracts, we ended up reviewing seven full-text articles, and data were extracted on important parameters such as demographic attributes of participants, sample size, and recurrence rate of hernia.
Results
Of the total studies that were reviewed, three were randomized controlled trials (RCT’s) and four retrospective observational studies. The sample size of all included studies varied between 80 to 176. The findings appear promising for the fascial closure as it showed an evidence of significant reduction in the recurrence rate with P = 0•047 in one out of the three RCT’s and in the retrospective observational studies reaching up to 16.7 % recurrence reduction rate. Likewise, there is also a reduction in the bulging, surgical site infection and seroma formation with higher patient’s satisfaction and quality of life score.
Conclusion
Primary fascial closure appears to be effective as it can decrease the rates of recurrence, seroma formation, bulging and improve patient’s satisfaction and quality of life. Given the dearth of studies, mainly randomized controlled trials, there is a need to carry out large randomized controlled trials with enough follow-up.