A comparative study of onlay & sublay mesh repair of ventral wall hernias in a tertiary care research centre

Abstract

Introduction: Ventral hernia is common in abdominal surgeries and is an important source of morbidity and mortality. Range of surgical techniques has been developed, from suturing techniques to various types of mesh repair. Mesh repair technique has shown a less number of postoperative complications and recurrence compared with other techniques. The bed on which mesh is placed is still debated. Among which one type being onlay and other being sublay are widely used but outcome of both is still controversial and do depend on surgeon’s choice of procedure. The purpose of this study was to compare the traditional on?lay mesh and sublay mesh placement in ventral hernia repairs in terms of time taken for surgery, duration of post-operative drainage, early and delayed complications. Materials and Methods: This is a prospective study which was conducted in the surgical department Navodaya Medical college hospital and research centre. A total of 50 cases in 1 years of duration were studied. Of these cases, 25 cases were managed by the on?lay mesh method and 25 by sublay mesh placement. Results: Operative time for sublay mesh placement was significantly higher than on?lay mesh repair, whereas, the duration of post-operative suction drainage was significantly lower in case of the sublay group. Superficial surgical site infection and seroma formation were statistically insignificant in both the study groups, although lesser in the sublay group. The recurrence rate was found to be 11% in on?lay mesh repair and 7% in sublay (retro rectus) mesh repair. Conclusions: Sublay mesh repair seems to be better method than onlay repair in duration of the post-operative suction drainage. In the sublay mesh repair group lower rate of complications and recurrence were seen. Keywords: Onlay, Sublay, Mesh Repair, Ventral hernias.