Comparative Study between Onlay and Sublay Placement of Polyproline Mesh in Ventral Hernia Repair

Abstract

Abstract Background Ventral hernia repair is one of the most common surgical operations performed all over the world. Onlay and sublay mesh repairs are the commonly performed techniques for the same. However, the debate still continues about the superiority of both techniques over each other. The aim of this study was to compare the outcome of the onlay versus sublay mesh repair for ventral hernia. Aim of the Work The purpose of this study is to compare between two techniques of mesh placement in uncomplicated ventral hernias, onlay (mesh on external oblique) versus sublay (mesh in the retromuscular space) regarding complications (superficial skin infection, seroma collection, operative time, hospital stay and 18 months recurrence rate. Patients and Methods The study frame is two years starting from August 2019 to August 2021 in general surgery department at Ain shams university hospital a. Total 60 adult patients who are scheduled to undergo hernioplasty for ventral abdominal wall hernias, 30 are included group A (onlay) and 30 in group B (sublay). Results Maior wound infection was 10% in the onlay group in coparison by the 3.3% of sublay group. Seroma is 33.3% in onlay group while 26.7% in sublay group. Recurrence rate is 6.7% in onlay while 3.3%in sublay group. Conclusion Our study revealed that ventral hernias are common in females more than males mainly in the fifth decade of life. Although there are many methods in repair such herniorraphy which associated with a high rate of recurrence so mesh repair is the best in such cases. We have found that sublay hernioplasty is better than onlay hernioplasty according to the post-operative complications such as recurrence, seroma formation and wound infection. However sublay hernioplsaty takes longer operative time than the onlay technique due to the disscection to get the retromuscular space, no significant statistical difference in the operative time., no significant blood loss and hospital stay between the two techniques.