Fourteen studies (six RCTs and eight non-randomised comparative studies) were included in the review (n=1,066). The follow-up ranged from two to 55 months. Methodological quality varied between trials. Randomisation was adequate in four RCTs, but allocation concealment was not adequately reported in most RCTs. Methods of patient allocation in non-randomised comparative studies appeared to be inadequate.
Hernia recurrence: Four RCTs reported that the hernia recurrence rate ranged from 0% to 6.3% in the laparoscopic repair group; the hernia recurrence rate ranged from 1.1% to 7% in the open repair group. Five non-randomised comparative studies reported that the hernia recurrence rate ranged from 0% to 9.5% in the laparoscopic repair group,; the hernia recurrence rate ranged from 0% to 61% in the open repair group.
Hospital stay: Six RCTs reported that laparoscopic ventral hernia repair was significantly associated with a shorter hospital stay compared with open ventral hernia repair. No significant differences in hospital stay between the two groups were reported in the six non-randomised comparative studies.
Operating time: Three RCTs reported that laparoscopic ventral hernia repair was significantly associated with a shorter operating time compared with open ventral hernia repair. Three RCTs did not find a difference in mean operating time between the two groups. Six non-randomised comparative studies reported a similar range of operating time between the two groups.
Conversion of laparoscopic to open surgery: Five RCTs reported no conversions from laparoscopic to open surgery and one RCT did not report this outcome. Four non-randomised comparative studies reported that the conversion rate ranged from 0% to 14%.
Four RCTs and eight non-randomised comparative studies reported that patients in the open repair group experienced more complications compared with those in the laparoscopic repair group.