Systematic review and network meta‐analysis of methods of mesh fixation during laparoscopic ventral hernia repair. BJS 2018; 105: 37-47.
Published: 11th December 2017
Authors: J. J. Baker, S. Öberg, K. Andresen, T. W. Klausen, J. Rosenberg
Ventral hernia repairs are common and have high recurrence rates. They are usually repaired laparoscopically with an intraperitoneal mesh, which can be fixed in various ways. The aim was to evaluate the recurrence rates for the different fixation techniques.
This systematic review included studies with human adults with a ventral hernia repaired with an intraperitoneal onlay mesh. The outcome was recurrence at least 6 months after operation. Cohort studies with 50 or more participants and all RCTs were included. PubMed, Embase and the Cochrane Library were searched on 22 September 2016. RCTs were assessed with the Cochrane risk‐of‐bias assessment tool and cohort studies with the Newcastle–Ottawa scale. Studies comparing fixation techniques were included in a network meta‐analysis, which allowed comparison of more than two fixation techniques.
Fifty‐one studies with a total of 6553 participants were included. The overall crude recurrence rates with the various fixation techniques were: absorbable tacks, 17·5 per cent (2 treatment groups); absorbable tacks with sutures, 0·7 per cent (3); permanent tacks, 7·7 per cent (20); permanent tacks with sutures, 6·0 per cent (25); and sutures, 1·5 per cent (6). Six studies were included in a network meta‐analysis, which favoured fixation with sutures. Although statistical significance was not achieved, there was a 93 per cent chance of sutures being better than one of the other methods.
Both crude recurrence rates and the network meta‐analysis favoured fixation with sutures during laparoscopic ventral hernia repair.Read more
You may also be interested in
Development and evaluation of a patient‐centred measurement tool for surgeons’ non‐technical skills.
Authors: J. Yule, K. Hill, S. Yule
Notes: Valid and reliable
Comparison of chlorhexidine–isopropanol with isopropanol skin antisepsis for prevention of surgical‐site infection after abdominal surgery.
Authors: J. C. Harnoss, O. Assadian, A. Kramer, P. Probst, C. Müller‐Lantzsch, L. Scheerer et al.
Notes: Chlorhexidine better
Construct and criterion validity testing of the Non‐Technical Skills for Surgeons (NOTSS) behaviour assessment tool using videos of simulated operations. BJS 2018; 105: 719-727.
Authors: S. Yule, A. Gupta, D. Gazarian, A. Geraghty, D. S. Smink, J. Beard et al.
Notes: Useful for research and education
Authors: S. Pengelly, J. E. A. Berry, S. E. Herrick, D. M. Bowley, G. L. Carlson
Notes: Most closed; hernia rates similar to primary closure
Postconditioning effects of argon or xenon on early graft function in a porcine model of kidney autotransplantation.
Authors: J. De Deken, S. Rex, E. Lerut, W. Martinet, D. Monbaliu, J. Pirenne et al.
Notes: No for noble gases
Authors: R. Mirnezami, A. Ahmed
Authors: O. Peacock, M. G. Bassett, A. Kuryba, K. Walker, E. Davies, I. Anderson et al.
Notes: Avoid unnecessary delay
Risk profile analysis and complications after surgery for autoimmune thyroid disease. BJS 2018; 105: 677-685.
Authors: O. Thomusch, C. Sekulla, F. Billmann, G. Seifert, H. Dralle, K. Lorenz et al.
Notes: Risk of postoperative hypoparathyroidism
Randomized clinical trial
Randomized clinical trial of platysma muscle suture versus no suture for wound closure after thyroid surgery. BJS 2018; 105: 645-649.
Authors: M. Senne, R. Zein, C. Falch, A. Kirschniak, A. Koenigsrainer, S. Müller et al.
Notes: No suture needed
Prediction of morbidity following cytoreductive surgery for metastatic gastrointestinal stromal tumour in patients on tyrosine kinase inhibitor therapy. BJS 2018; 105: 743-750.
Authors: M. Fairweather, M. J. Cavnar, G. Z. Li, M. M. Bertagnolli, R. P. DeMatteo, C. P. Raut et al.
Notes: May help treatment planning
Authors: S. K. Hong, K. W. Lee, Y. Choi, H. S. Kim, S. W. Ahn, K. C. Yoon et al.
Notes: Long learning curve even for experienced surgeons