title: A systematic review comparing single-incision versus multi-incision laparoscopic surgery for inguinal hernia repair with mesh.
abstract: OBJECTIVE
  The objective of this article is to evaluate whether the surgical outcomes differ between single incision laparoscopic surgery (SILS) versus multi-incision laparoscopic surgery (MILS) for the repair of inguinal hernia.
  
  
  METHODS
  A systematic review of the literature on published studies reporting the surgical outcomes following SILS versus MILS for inguinal hernia repair was undertaken using the principles of meta-analysis.
  
  
  RESULTS
  Fifteen comparative studies on 1651 patients evaluating the surgical outcomes in patients undergoing SILS versus MILS for inguinal hernia repair were systematically analysed. The post-operative recovery time was significantly quicker [odds ratio, -0.35 (CI, -0.57 - 0.14), p = 0.001] following SILS compared to MILS procedure. However, the statistical equivalence was seen in outcomes of length of hospital stay, operative time both for unilateral and bilateral hernias, post-operative pain score, one-week pain score, hernia recurrence [odds ratio, 1.24 (CI, 0.47-3.23), p = 0.66], conversion [odds ratio, 1.07 (CI, 0.37-3.12), p = 0.90], and post-operative complications [odds ratio, 0.95 (CI, 0.66-1.36, p = 0.78] between two approaches. The sub-group analysis of four included randomized, controlled trials showed similarities between outcomes following SILS and MILS except slightly higher postoperative pain score in MILS group.
  
  
  CONCLUSIONS
  Both SILS and MILS approaches of inguinal hernia repair are feasible, safe and can be offered to patients depending upon the availability of expertise and resources.
authors.affiliation: Department of General, Endoscopic and Laparoscopic Colorectal Surgery, Western Sussex Hospitals NHS Trust, Worthing Hospital, Worthing, West Sussex, BN11 2DH, UK. Electronic address: surgeon1wrh@hotmail.com.
authors.forename: M S
authors.initials: MS
authors.lastname: Sajid
authors.affiliation: Department of General, Endoscopic and Laparoscopic Colorectal Surgery, Western Sussex Hospitals NHS Trust, Worthing Hospital, Worthing, West Sussex, BN11 2DH, UK.
authors.forename: A H
authors.initials: AH
authors.lastname: Khawaja
authors.affiliation: Department of General, Upper Gastrointestinal & Hepato-pancreatico-biliary Surgery, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital Worthing, West Sussex, BN11 2DH, UK.
authors.forename: M
authors.initials: M
authors.lastname: Sayegh
authors.affiliation: Department of General, Endoscopic and Laparoscopic Colorectal Surgery, Western Sussex Hospitals NHS Trust, Worthing Hospital, Worthing, West Sussex, BN11 2DH, UK.
authors.forename: M K
authors.initials: MK
authors.lastname: Baig
mesh_terms: D018849:Controlled Clinical Trials as Topic; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D013526:Surgical Mesh; D000072836:Surgical Wound
keywords: Inguinal hernia; Laparoscopic hernia repair; Multi-incision repair; Single incision repair