***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: BACKGROUND To analyze hospital re source utilization for  laparoscopic vs open incisional hernia repair including the postoperative period . METHODS Prospect ively collected administrative data for incisional hernia repairs  were examined . A total of 884 incisional hernia repairs  were examined for trends in type of approach over time . Starting October 2001 , detailed records were available , and examined for operating room ( OR ) time , cost data , length of stay ( LOS ) , and 30-day postoperative hospital encounters . RESULTS Of the total , 469 incisional hernias were approached laparoscopically ( 53 % ) and 415 open ( 47 % ) . Laparoscopic repair had shorter LOS ( 1 + /- 0.2 days vs 2 + /- 0.6 days ) , longer OR time ( 149 + /- 4 min vs 89 + /- 4 min ) , higher supply costs ( 2,237 dollars + /- 71 dollars vs 664 dollars + /- 113 dollars ) , slightly lower total hospital cost ( 6,396 dollars + /- 477 dollars vs 7,197 dollars + /- 1,819 dollars ) , and slightly more postoperative hospital encounters ( 15 % vs 13 % ) . Use of laparoscopy increased over time ( 37 % in 2000 vs 68 % in 2004 ) . CONCLUSIONS Laparoscopic incisional hernia repair is becoming increasingly popular , and not at increased cost to the health care system Objective : The aim of the trial was to compare laparoscopic technique with open technique regarding short-term pain , quality of life ( QoL ) , recovery , and complications . Background : Laparoscopic and open techniques for incisional hernia repair are recognized treatment options with pros and cons . Methods : Patients from 7 centers with a midline incisional hernia of a maximum width of 10 cm were r and omized to either laparoscopic ( LR ) or open sublay ( OR ) mesh repair .  Primary end point was pain at 3 weeks , measured as the bodily pain subscale of Short Form-36 ( SF-36 ) . Secondary end points were complications registered by type and severity ( the Clavien-Dindo classification ) , movement restrictions , fatigue , time to full recovery , and QoL up to 8 weeks . Results : Patients were recruited between October 2005 and November 2009 . Of 157 r and omized patients , 133 received intervention : 64 LR and 69 OR . Measurements of pain did not differ , nor did movement restriction and postoperative fatigue . SF-36 subscales favored the LR group : physical function ( P < 0.001 ) , role physical ( P < 0.012 ) , mental health ( P < 0.022 ) , and physical composite score ( P < 0.009 ) . Surgical site infections were 17 in the OR group compared with 1 in the LR group ( P < 0.001 ) . The severity of complications did not differ between the groups ( P < 0.213 ) . Conclusions : Postoperative pain or recovery at 3 weeks after repair of midline incisional hernias does not differ between LR and OR , but the LR results in better physical function and less surgical site infections than the OR does . ( Clinical Trials.gov Identifier : NCT00472537 Background The laparoscopic approach has emerged in the search for a surgical technique to decrease the morbidity associated with conventional repair of ventral hernias . In this study we aim ed to compare the results of our open and laparoscopic ventral hernia repairs prospect ively . Methods Between January 2001 and October 2005 , a total of 46 patients diagnosed with ventral hernias ( primary and incisional ) who were admitted to our surgical unit and accepted to be included in this study group were examined . All patients were divided into laparoscopic repair ( n = 23 ) and open repair  ( n = 23 ) subgroups in a r and omized fashion . The patients ’ demographic characteristics , operation times , body mass indices , sizes of fascial defects , hernia locations , duration s of hospital stay , presence and degrees of postoperative pain , and postoperative minor and major complications were analysed and compared . All the data were expressed as means ± SDs . Chi-square and Wilcoxon tests were used for statistical analysis , and P < 0.05 was accepted as a significant statistical value ( SPSS 11.0 for Windows ) . Results The demographic characteristics of both groups were similar . Women predominated , especially in the laparoscopy group ( P < 0.05 ) . The comparison of the results revealed that the major advantage of laparoscopy was the shortened postoperative hospital stay and the reduced incidence of mesh infection ( P < 0.05 , P < 0.05 ) . On the other h and , operation time was significantly longer in the laparoscopy group ( P < 0.05 ) . The major complications encountered in the laparoscopy group were ileus and a missed enterotomy . The most frequent minor complication was seroma , which was significantly more frequent in the laparoscopy group ( P < 0.05 ) . Postoperative pain assessment revealed similar results in both groups ( P > 0.05 ) . Conclusions The laparoscopic approach appears to be as effective as open repairs in the treatment of ventral hernias . Advanced surgical skill , laparoscopic experience and high technology are m and atory factors for successful ventral hernia repair BACKGROUND The objective of this quasi experimental study was to compare the frequency of wound infection between  open cholecystectomy ( OC ) and laparoscopic cholecystectomy ( LC ) conducted in Surgical Unit IV , Jinnah Hospital Lahore from June 2005 to January 2006 . METHODS 100 patients undergoing elective cholecystectomy for symptomatic gallstones were studied . The patients were allocated in the two groups of 50 each by simple r and om technique . Group-I underwent OC and Group-II underwent LC . The patients were then followed up for four weeks to pick up signs of wound infection . In case of infection , the degree of infection and the remedial measures done were documented and the results analysed . RESULTS In LC group there was only one case of Class-II wound infection i.e. 2 % . In case of OC there were three cases of wound infection i.e. 6 % . Out of these , two were of Class-IIl and one of Class-Il . CONCLUSION While there was no wound infection in cases of chronic Cholecystitis in both groups , the frequency of wound infection was three times as common in OC as compared to LC in Acute Cholecystitis/Empyema Objective : The objective of this study was to determine the best treatment of incisional hernia , taking into account recurrence , complications , discomfort , cosmetic result , and patient satisfaction . Background : Long-term results of incisional hernia repair are lacking . Retrospective studies and the midterm results of this study indicate that mesh repair is superior to suture repair . However , many surgeons are still performing suture repair . Methods : Between 1992 and 1998 , a multicenter trial was performed , in which 181 eligible patients with a primary or first-time recurrent midline incisional hernia were r and omly assigned to suture or mesh repair .  In 2003 , follow-up was up date d. Results : Median follow-up was 75 months for suture repair and 81 months for mesh repair patients . The 10-year cumulative rate of recurrence was 63 % for suture repair and 32 % for mesh repair ( P < 0.001 ) . Abdominal aneurysm ( P = 0.01 ) and wound infection ( P = 0.02 ) were identified as independent risk factors for recurrence . In patients with small incisional hernias , the recurrence rates were 67 % after suture repair and 17 % after mesh repair ( P = 0.003 ) . One hundred twenty-six patients completed long-term follow-up ( median follow-up 98 months ) . In the mesh repair group , 17 % suffered a complication , compared with 8 % in the suture repair group ( P = 0.17 ) . Abdominal pain was more frequent in suture repair patients ( P = 0.01 ) , but there was no difference in scar pain , cosmetic result , and patient satisfaction . Conclusions : Mesh repair results in a lower recurrence rate and less abdominal pain and does not result in more complications than suture repair . Suture repair of incisional hernia should be ab and oned IMPORTANCE Incisional hernia is the most frequent surgical complication after laparotomy . Up to 30 % of all patients undergoing laparotomy develop an incisional hernia . OBJECTIVE To compare laparoscopic vs open ventral incisional hernia repair with regard to postoperative pain and nausea , operative results , perioperative and postoperative complications , hospital admission , and recurrence rate . DESIGN Multicenter r and omized controlled trial between May 1999 and December 2006 with a mean follow-up period of 35 months . SETTING All patients were operated on in a clinical setting at 1 of the 2 participating university medical centers or at the other 8 teaching hospitals . PARTICIPANTS Two hundred six patients from 10 hospitals were r and omized equally to laparoscopic or open mesh repair . Patients with an incisional hernia larger than 3 cm and smaller than 15 cm , either primary or recurrent , were included . Patients were excluded if they had an open abdomen treatment in their medical histories . INTERVENTION Laparoscopic or open ventral incisional hernia repair . MAIN OUTCOME MEASURES The primary outcome of the trial was postoperative pain . Secondary outcomes were use of analgesics , perioperative and postoperative complications , operative time , postoperative nausea , length of hospital stay , recurrence , morbidity , and mortality . RESULTS Median blood loss during the operation was significantly less ( 10 mL vs 50 mL ; P = .05 ) as well as the number of patients receiving a wound drain ( 3 % vs. 45 % ; P < .001 ) in the laparoscopic group . Operative time for the laparoscopic group was longer ( 100 minutes vs. 76 minutes ; P = .001 ) . Perioperative complications were significantly higher after laparoscopy ( 9 % vs. 2 % ) . Visual analog scale scores for pain and nausea , completed before surgery and 3 days and 1 and 4 weeks postoperatively , showed no significant differences between the 2 groups . At a mean follow-up period of 35 months , a recurrence rate of 14 % was reported in the open group and 18 % , in the laparoscopic group ( P = .30 ) . The size of the defect was found to be an independent predictor for recurrence ( P < .001 ) . CONCLUSIONS AND RELEVANCE During the operation , there was less blood loss and less need for a wound drain in the laparoscopic group . However , operative time was longer during laparoscopy . Perioperative complications were significantly higher in the laparoscopic group . Visual analog scores for pain and nausea did not differ between groups . The incidence of a recurrence was similar in both groups . The size of the defect was found to be an independent factor for recurrence of an incisional hernia BACKGROUND Laparoscopic repair of ventral incisional hernias  has not been proved to be safer than open mesh repair . DESIGN Prospect i ve r and omized trial conducted between February 1 , 2004 , to January 31 , 2007 . SETTING Four Veterans Affairs medical centers . PARTICIPANTS One hundred sixty-two patients with ventral incisional hernias . INTERVENTIONS St and ardized laparoscopic or open repair . MAIN OUTCOME MEASURES Overall complication rates at 8 weeks and the odds of complications , adjusted for study site , body mass index , and hernia type . RESULTS Of the 162 r and omized patients , 146 underwent surgery ( 73 open and 73 laparoscopic repairs ) . Complications were less common in the laparoscopic group ( 23 patients [ 31.5 % ] ) compared with the open repair group ( 35 patients [ 47.9 % ] ; adjusted odds ratio [ AOR ] , 0.45 ; 95 % confidence interval [ CI ] , 0.22 - 0.91 ; P = .03 ) . Surgical site infection through 8 weeks was less common in the laparoscopic group ( 5.6 % vs 23.3 % ; AOR , 0.2 ; 95 % CI , 0.1 - 0.6 ) . The mean worst pain score in the laparoscopic group was 15.2 mm lower on a visual analog scale at 52 weeks ( 95 % CI , 1.0 - 29.3 ; P = .04 ) . Time to resume work activities was shorter for the laparoscopic group than for the open repair group ( median , 23.0 days vs 28.5 days ) , with an adjusted hazard ratio of 0.54 ( 95 % CI , 0.28 - 1.04 ; P = .06 ) . Overall recurrence at 2 years was 12.5 % in the laparoscopic group and 8.2 % in the open repair group ( AOR , 1.6 ; 95 % CI , 0.5 - 4.7 ; adjusted P = .44 ) . CONCLUSIONS Laparoscopic repair was associated with fewer 
    Output:
    
Conclusions On the basis of our meta- analysis , we conclude that laparoscopic and open repair of incisional hernia is comparable .