Laparoscopic treatment of ventral hernias: the Italian national guidelines
Fabio Cesare Campanile, Mauro Podda, Francesca Pecchini, Marco Inama, Sarah Molfino, Marco Augusto Bonino, Monica Ortenzi, Gianfranço Silecchia, Ferdinando Agresta, Michela Cinquini, the Italian Laparoscopic Ventral Hernia Guideline Group, Ferdinando Agresta, Roberto Cirocchi, Micaela Piccoli, Nereo Vettoretto, Fabio Cesare Campanile, Michela Cinquini, Elena Albanese, Luca Ansaloni, Armando Antinori, Paolo Baccari, Rossana Berta, Graziano Ceccarelli, Diego Cuccurullo, Francesco Diomede, Clelia Esposito, Giovanni Ferrari, Guendalina Graffigna, Roberta Monzani, Stefano Olmi, Tiziana Placidi, Marco Augusto Bonino, Marco Inama, Sarah Molfino, Francesca Pecchini, Mauro Podda, Alice Clerici, Victor G. Radu, Gianfranco Silecchia
Abstract
Primary and incisional ventral hernias are significant public health issues for their prevalence, variability of professional practices, and high costs associated with the treatment In 2019, the Board of Directors of the Italian Society for Endoscopic Surgery (SICE) promoted the development of new guidelines on the laparoscopic treatment of ventral hernias, according to the new national regulation. In 2022, the guideline was accepted by the government agency, and it was published, in Italian, on the SNLG website. Here, we report the adopted methodology and the guideline's recommendations, as established in its diffusion policy. This guideline is produced according to the methodology indicated by the SNGL and applying the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) methodology. Fifteen recommendations were produced as a result of 4 PICO questions. The level of recommendation was conditional for 12 of them and conditional to moderate for one. This guideline's strengths include relying on an extensive systematic review of the literature and applying a rigorous GRADE method. It also has several limitations. The literature on the topic is continuously and rapidly evolving; our results are based on findings that need constant re-appraisal. It is focused only on minimally invasive techniques and cannot consider broader issues (e.g., diagnostics, indication for surgery, pre-habilitation).