Comparative study between the sublay versus onlay techniques of mesh hernioplasty in case of ventral hernias

Abstract

Background: Abdominal hernias are common surgical conditions that can be presented as emergency and elective surgeries. Ventral hernia repair has always been a major challenge for surgeons. The mesh hernioplasty method has been considered the golden option for preventing or minimizing the incidence of recurrence, but the question is where surgeons should place the mesh or onlay. Objective: To compare the onlay versus sublay technique for ventral hernia in terms of performance and outcome. Methodology: Prospective study (120) of patients undergoing ventral hernia repair. We collect our cases for three years from (May 1, 2017 to May 2020) and will continue until (January 2022). Sixty patients were treated with onlay mesh repair (group A) and 60 patients were treated with underlay mesh repair (group B). Data collected in both groups were performed with respect to operative time, placement, and time required for drain removal, wound infection, and recurrence rate. Follow-up was performed every three months for 24 months. Data were analyzed using SPSS version 18, Fisher's exact test as appropriate; a p-value less than 0.05 was considered statistically significant.Results: In the sublay group, seroma formation was found in two patients (3.33%), while in 12 (20%) in the onlay group. Wound infection was found in one patient (1.66%) in the sublay group and 6 (10%) in the onlay group. no septic mesh was removed in the sublayer group, one mesh was removed in the onley type. In the onlay group, recurrence was found in 4 patients (6.66%), while no recurrence occurred in the sublay group. Conclusion: Sublay mesh hernioplasty is a better alternative to onlay mesh hernioplasty for all forms of ventral hernias.