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1040 Abdominal wall closure in gynaecology: a systematic review
  1. Josh Courtney Mcmullan1,
  2. Jolanda Van Keizerswaard2,
  3. Laurie Smith1,
  4. Jared Torkington1,
  5. Eva Deerenberg3 and
  6. Sadie Jones1
  1. 1University Hospital of Wales, Cardiff, UK
  2. 2Erasmus Medical Centre, Rotterdam, The Netherlands
  3. 3Franciscus Gasthuis and Vlietland, Rotterdam, The Netherlands


Introduction/Background Incisional hernias (IH) are frequent complications of abdominal surgery with an incidence of 12.8% following a midline incision and one-third require surgical repair. Recurrence rates range between 23–50%, increasing after each subsequent failed repair. Female sex has now also been identified as an independent risk factor for chronic pain following IH repair. The European Hernia Society (EHS) has published guidelines on closure of abdominal wall incisions. Multiple updates on abdominal wall closure have been identified in systematic reviews and meta-analyses, which have been widely adopted by the general surgical community.

Methodology We established a steering committee and Key Questions (KQs) were formulated, with relevant agreed search terms, and translated into patients-intervention-comparison-outcome (PICO) formats. A primary literature search for all the KQs included MEDLINE, EMBASE and The Cochrane Library from January2012-May2023. Randomised controlled trials, systematic reviews, meta-analyses and observational/cohort studies (relevant to gynaecology) were included. Case reports, case series, conference abstracts, expert opinions and protocol papers were also excluded. Following a review of title and abstracts, papers were excluded if not relevant to this study which included incisional hernia repair, operated through incisions not on the ventral abdomen, extraction sites, children or pregnant women (due to change in physiology during pregnancy).

Results 2518 papers were screened by title and abstract and 51 full texts were assessed for eligibility. Data analysis is ongoing within the steering group and due to be completed in January 2024, in collaboration with the European Hernia Society (EHS).

Conclusion Incisional hernias are a common complication of abdominal surgery, particularly following midline laparotomy. Gynaecological oncology patients often undergo surgery of this nature and female sex has been identified as an independent risk factor for chronic pain following IH repair. Consensus statement guidelines, relevant to gynaecology, should be produced to ensure a standardised approach to abdominal surgery within gynae-oncology.

Disclosures None to declare.

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