Published studies of any type that reported on a case or case series of patients with acute, chronic, strangulated, incarcerated or irreducible Spigelian hernias or asymptomatic Spigelian hernias managed on an elective or emergency basis using the laparoscopic approach were eligible for inclusion. Studies of paediatric hernias and studies that reported on the open approach were excluded. Studies where data extraction was not possible were excluded.
More than half of the procedures were performed electively and a few were performed in the emergency setting. Laparoscopic approaches included intraperitoneal onlay mesh, transabdominal preperitoneal patch, total extraperitoneal patch and laparoscopic suturing. In a small proportion of cases, concurrent conditions were managed simultaneously. Studies were undertaken in UK, USA, China, Spain, Turkey, France, India, Holland, Italy and Australia.
The authors did not state how many reviewers selected studies for the review.