Abstract:

Objective

To evaluate the advantages and disadvantages of preserving or transecting the round ligament of uterus during laparoscopic inguinal hernia repair in women.

Methods

Relevant studies were collected from PubMed， Embase， Cochrane Library， Web of Science， Baidu Academic， CNKI and Wanfang database on the preservation or transection of the round ligament of the uterus during endoscopic repair in female inguinal hernia.The data were statistically analyzed with RevMan5.3.The primary outcomes included the operation time， postoperative seroma， postoperative pain， hospital stay， bleeding volume and recurrence of hernia.

Results

11 randomized controlled trials including 1 443 patients （749 patients in experiment group， 697 patients in control group） were collected.Preserving or transecting the round ligament of the uterus during laparoscopic inguinal hernia repair in women， the operation time （MD=6.69， 95% CI：3.48-9.91， P＜0.000 1） was statistically significant.There was no statistical difference in postoperative seroma （OR=0.71， 95% CI： 0.38-1.30， P=0.27）， postoperative pain （OR=1.56， 95% CI： 0.76-3.24，P=0.23），hospital stay （MD=-0.58， 95% CI： -1.55-0.40， P=0.25）， bleeding volume （MD=-1.05， 95% CI： -2.66-0.76， P=0.23） and recurrence of hernia （OR=0.47， 95% CI： 0.07-3.36， P=0.44）.

Conclusions

During laparoscopic inguinal hernia repair in women， preserving the round ligament of uterus can prolong the operation time.Without obviously affecting the efficacy and recovery， the integrity of the uterine round ligament should be actively preserved to avoid damaging its function.Other clinical effects caused by preserving or transecting the round ligament of uterus need more clinical data and research.

Key words: Round ligament of uterus, Laparoscopes, Hernia， inguinal, Hernia repair, Female