Systematic review and meta-analysis compares single-port versus two-port laparoscopic pediatric inguinal hernia repair

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Frontiers in Medicine Published May 8, 2026 Medically reviewed May 8, 2026 DOI ↗ By Dr. Sofia Müller, MD · Lifespan & Whole-Person Care

Key Takeaway

Consider the lower recurrence rate with single-port laparoscopic repair, but note other outcomes were similar.

This is a systematic review and meta-analysis of studies comparing transumbilical single-port laparoscopic surgery to two-port laparoscopic surgery for pediatric inguinal hernia repair. The analysis included a total sample size of 22,846 children.

The key synthesized finding was a significantly lower postoperative recurrence rate with the single-port approach, with a pooled risk ratio (RR) of 0.60 (95% CI: 0.39 to 0.94, P = 0.02). For operation time, there was no statistically significant difference overall (MD = -1.43; 95% CI: -3.42 to 0.57, P = 0.16), though it was significantly shorter in large sample size studies (MD = -4.27). Hospital stay, detection rate of contralateral occult hernia, conversion to open surgery rate, and incidence of various postoperative complications all showed no statistically significant differences.

The authors note that follow-up duration was not reported. Limitations of the evidence were not detailed in the provided data. The review's authors suggest it provides high-quality evidence-based medical evidence for the selection of clinical surgical methods, though this framing should be interpreted cautiously given the unspecified evidence quality.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedMay 2026

View Original Abstract ↓

ObjectiveTo systematically evaluate the perioperative efficacy and safety of transumbilical single-port laparoscopic surgery and two-port laparoscopic surgery in the treatment of pediatric inguinal hernia, and to provide high-quality evidence-based medical evidence for the selection of clinical surgical methods.MethodsA comprehensive search was conducted in PubMed, Embase, Cochrane Library, and Web of Science databases to collect relevant controlled studies published from the establishment of the databases to December 31, 2025. After screening the literature and extracting data according to the pre-set inclusion and exclusion criteria, the ROB2 tool and ROBINS-I tool were used to evaluate the risk of bias in RCT and non-RCT studies, respectively. Meta-analysis was performed using RevMan 5.3 software and R software.ResultsA total of 13 studies were included, involving 22,846 children. Meta-analysis showed that the postoperative recurrence rate in the single-port laparoscopic group was significantly lower than that in the two-port laparoscopic group (RR = 0.60, 95% CI: 0.39–0.94, P = 0.02); there were no statistically significant differences between the two groups in terms of operation time (MD = −1.43, 95% CI: −3.42–0.57, P = 0.16), hospital stay (MD = −2.34, 95% CI: −7.73–3.06, P = 0.40), detection rate of contralateral occult hernia (RR = 1.03, 95% CI: 0.94–1.13, P = 0.55), conversion to open surgery rate (RR = 1.57, 95% CI: 0.14–17.93, P = 0.71), and the incidence of various postoperative complications (all P > 0.05). Subgroup analysis showed that in large sample size studies, the operation time in the single-port laparoscopic group was significantly shorter (MD = −4.27, 95% CI: −7.25–1.28, P