title: Single-incision laparoscopic hernioplasty versus multi-incision laparoscopic hernioplasty: a meta-analysis.
abstract: BACKGROUND
  Laparoscopic hernioplasty is the gold standard treatment for inguinal hernias. Recently, single-incision laparoscopic hernioplasty (SILH) has been suggested as an alternative technique. It is not evident whether the benefits of this procedure overcome the potential increased risk.
  
  
  OBJECTIVE
  The aim of this study was to compare the outcomes of SILH with conventional multi-incision laparoscopic hernioplasty (MILH) using a meta-analysis of available controlled clinical trials.
  
  
  METHODS
  Eligible articles were identified by searching several databases including Embase, Cochrane, PubMed and Google Scholar databases, up until May 2013. Evaluated outcomes were operative time, post-operative hospital stay, complications, conversion and recurrence.
  
  
  RESULTS
  Eight controlled clinical trials on 926 patients were randomized to either SILH (495 patients) or MILH (431 patients) for meta-analysis. Overall, there was no significant difference between SILH and MILH in complications, operative time for bilateral inguinal hernia repair, hospital stay, short-term recurrence or conversions. However, the operative time for unilateral inguinal hernia repair was significantly longer for SILH than for MILH (standardized mean difference 0.23 (95% confidence interval: 0.09-0.38); P = 0.00, I(2) = 73.6%).
  
  
  CONCLUSIONS
  Our meta-analysis showed that SILH is feasible and safe in certain patients when compared to MILH, and carries a similar outcome, with the exception of longer operative times for unilateral inguinal hernia repair. Additional high-powered randomized trials are needed to determine whether SILH truly offers any advantages; these future studies should focus particularly on failure of technique, pain score, analgesia requirements, cosmesis and quality of life.
authors.affiliation: Department of Gastrointestinal Surgery, Tumor Hospital of Guangxi Medical University, Nanning, Guangxi Autonomous Region, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Lai
authors.forename: Guojian
authors.initials: G
authors.lastname: Li
authors.forename: Jun
authors.initials: J
authors.lastname: Xiao
authors.forename: Yuan
authors.initials: Y
authors.lastname: Lin
authors.forename: Bangyu
authors.initials: B
authors.lastname: Lu
mesh_terms: D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*
keywords: SILH.; hernioplasty; inguinal hernia; laparoscopy; meta-analysis