{
  "abstract": "Background/Objectives: Port-site hernia (PSH) is a known complication of laparoscopic and robotic surgery, but whether routine fascial closure reduces this risk remains unclear. We examined the association between fascial closure and PSH compared with non-closure. Methods: This systematic review and meta-analysis followed PRISMA and was registered in PROSPERO (CRD420251274471). Embase, MEDLINE, APA PsycInfo, Global Health, and HMIC were searched for English-language studies up to 7 March 2026. Randomized trials and comparative observational studies reporting PSH after fascial closure versus non-closure were included. Non-comparative studies and studies without extractable PSH data were excluded. We used random-effects meta-analysis, RoB 2 and ROBINS-I for risk of bias, and GRADE to assess certainty of evidence. Results: Ten studies including 2183 patients (3 randomized trials and 7 observational studies) met the inclusion criteria. Overall, fascial closure was not associated with a statistically significant reduction in PSH (RR 0.51, 95% CI 0.25–1.07; I2 = 72%). The findings remained non-significant when randomized trials (RR 0.81, 95% CI 0.15–4.38) and observational studies (RR 0.45, 95% CI 0.19–1.06) were considered separately. In a post hoc analysis limited to studies with balanced follow-up, PSH was less frequent after closure (RR 0.38, 95% CI 0.20–0.73). Four observational studies were at serious risk of bias, and certainty of evidence ranged from very low to low. Conclusions: The available evidence does not provide a clear answer on whether routine fascial closure reduces PSH. No included study evaluated robotic procedures. More randomized studies with consistent closure techniques and adequate follow-up are needed.",
  "abstract_shown": true,
  "affiliations": [
    "2nd Department of Obstetrics and Gynecology, “Aretaieion” University Hospital, 115 28 Athens, Greece",
    "Department of Obstetrics and Gynecology, Spital Männedorf, 8708 Männedorf, Switzerland"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Dimitrios Balafoutas",
      "orcid": "0000-0002-6256-2127"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Konstantinos Stavridis",
      "orcid": "0000-0001-6921-0573"
    },
    {
      "affs": [
        0
      ],
      "name": "Panagiotis Christopoulos",
      "orcid": "0000-0003-4112-8396"
    },
    {
      "affs": [
        0
      ],
      "name": "Panagiotis Vakas"
    },
    {
      "affs": [
        0
      ],
      "name": "Nikos Vlahos"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6wk09a4gn91r1.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15218280",
  "fulltext_url": null,
  "id": "6wk09a4gn91r1",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/21/8280",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Minimally Invasive Surgical Techniques"
    ]
  ],
  "openalex": "W7223874418",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-24",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/6wk09a4gn91r1.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:01Z",
      "native_id": "10.3390/jcm15218280",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/21/8280"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Minimally Invasive Surgical Techniques",
      "subfield": "surgery"
    }
  ],
  "title": "Fascial Closure and the Occurrence of Port-Site Hernia After Laparoscopic Surgery: A Systematic Review and Meta-Analysis",
  "title_text": "Fascial Closure and the Occurrence of Port-Site Hernia After Laparoscopic Surgery: A Systematic Review and Meta-Analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:01Z",
  "url": "https://research.draconitic.com/paper/6wk09a4gn91r1",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}