Anterior Abdominal Wall Defects Research Articles

Chest radiographic thoracic areas and respiratory outcomes in infants with anterior abdominal wall defects.

Infants with anterior abdominal wall defects (AWD) can suffer from pulmonary complications. Our aims were to determine if the chest radiographic thoracic areas (CRTAs) on day one differed between infants with exomphalos or gastroschisis, whether this related to differing severity of outcomes and if they were lower than those of controls indicating abnormal antenatal lung growth. A review of infants with exomphalos or gastroschisis born between January 2004 and January 2023 was conducted. The control group was term, newborn infants ventilated for poor respiratory drive at birth. Chest radiographs on day one were analysed and the highest CRTA in the first 24 h after birth for each infant included in the analysis. The 127 infants with gastroschisis had a lower gestational age and birthweight than the 62 exomphalos infants and 130 controls (all p<0.001) The CRTAs of the controls were greater than the CRTAs of the exomphalos and the gastroschisis infants (p = 0.001). The median CRTA corrected for birthweight was lower in the exomphalos infants [688, IQR 568-875 mm2/kg] than the gastroschisis infants [813, IQE 695-915 mm2/kg] No gastroschisis infant developed bronchopulmonary dysplasia (BPD). A CRTA of 1759 mm2 had a sensitivity of 81 % and specificity of 71 % in predicting BPD in infants with exomphalos. Infants with gastroschisis or exomphalos had lower CRTAs than controls suggesting both groups had abnormal antenatal lung development. The CRTA was lower in the exomphalos infants who also had worse respiratory outcomes, hence CRTA assessment may a useful prognostic aid.

Umblikal Hernili Hastaların Değerlendirilmesi: 6 Yıllık Deneyim

Objective: Umbilical hernia is a common anterior abdominal wall defect in childhood. Although the defect is present at birth, unlike other hernias of childhood, it may close spontaneously over time without the need for surgery. However, when these hernias do not close spontaneously, complications can develop that require emergency surgery. The aim of this study was to determine the incidence of spontaneous closure in patients diagnosed with umbilical hernia and the factors that influence this incidence, the complications that may develop during follow-up, the indications for surgery and the issues to consider when planning the follow-up of patients. Material and Methods: Between January 2006 and December 2011, 1928 patients diagnosed with umbilical hernia and followed up and treated in our clinic were included in the study. In this retrospective cohort study the current size of umbilical hernia, comorbidities and demographic characteristics of the patients were analysed. Operative data, complications and postoperative follow-up of the operated patients were evaluated. Results: The spontaneous closure rate of umbilical hernia was found to be 60%. The rate of spontaneous closure of umbilical hernia was higher in boys and the rate of operation was higher in girls. The risk of incarceration was higher in girls than in boys. The rate of spontaneous closure decreased with increasing defect size. It was found that comorbidities did not affect spontaneous closure of umbilical hernias. The rate of emergency surgery for incarceration was low (2%). Strangulation was noted in 1% of patients. All patients with incarceration were in Lassaletta group 2 (defect diameter 0.5-1.5 cm). Conclusion: Conservative management is still the most accepted and safest method in the treatment of umbilical hernia. Incarceration and strangulation are very rare in umbilical hernias. Even if the umbilical hernia is complicated, surgical treatment is possible and peri- and post-operative complication rates are very low. Long-term morbidity and mortality due to incarceration have not been reported in the literature.

The Long-Term Outcome of Abdominal Wall Defects Exomphalos &amp; Gastroschisis Retrospective Single Centre Study Children Hospital at Westmead, Sydney, Australia

Objective: To examine the natural history and detailed outcome of diagnosed cases of abdominal wall defects that admitted to The Children`s Hospital at Westmead. Methods: This was A retrospective single centre study of all cases of abdominal wall defects admitted between the 1st of October 1998 and the 1st of January 2007 to The Children`s Hospital at Westmead. The study had been conducted through a retrospective review of the neonatal, pediatric surgery records and subsequent follow-up information of all cases of Omphalocele and Gastroschisis diagnosed. Results: Ninety cases with anterior abdominal wall defects were admitted. Majority of the cases were born at Westmead Hospital. There were 25 neonates with Gastroschisis (27 females, 28 males), and 35 neonates with Exomphalos (15 females, 20 males). Eighty-one neonates had prenatal ultrasound diagnosis. Some neonates had associated congenital anomalies which results in five deaths (4 Exomphalos, 1 Gastroschisis). Post operative complications were common and the postoperative hospital stay was often lengthy. Twenty-five patients out of the ninety (15 Gastroschisis, 10 exomphalos) required further operations which were related to their primary diagnosis of Gastroschisis or Exomphalos, mostly for abdominal wall hernias. Conclusions: Long-term outcome was favourable in majority of cases with abdominal wall defects and mortality substantially happened in neonates with associated anomalies. Reoperations were necessary in those patients who had postoperative hernias.

190 días de pentalogía de cantrell: reporte de caso y revisión de tema

Cantrell Pentalogy is a rare congenital anomaly that affects the development of organs in the thorax and abdomen of a fetus, characterized by five primary defects: anterior abdominal wall defects, sternal defects, diaphragmatic defects, cardiac anomalies, and defects in other organs such as lungs, liver, kidneys, and central nervous system. It is named after the American physician Everett R. Cantrell, who first described the condition in 1958. Cantrell Pentalogy is an extremely rare and severe condition, often associated with high mortality rates due to respiratory and cardiac complications. Treatment typically involves early-life surgical repair; however, the prognosis remains guarded and depends on the severity of the defects and the presence of other associated anomalies. This case report presents the diagnosis of Cantrell Pentalogy in a female patient at birth and provides a 190-day follow-up of her condition.

Development of the Acellular Dermal Matrix and Experimental Substantiation of Its Use in the Anterior Abdominal Wall hernia Repair

Objective: To develop a biological implant that is an acellular dermal matrix (ADM), evaluate its use as a support material in tensionfree hernioplasty for ventral hernia, and compare it to that of the commercially available implant PermacolTM. Materials and methods: ADM was derived from the porcine dermis (Landrace breed) decellularized using detergents and enzymes. The quality of devitalization was assessed in vitro. We performed sublay hernioplasty in 4-month-old Landrace pigs using ADM (experimental group) and PermacolTM (control group). The specimens were explanted on day 120 of the experiment for histological and immunohistochemical examination. Results: All cellular elements were removed by the detergent-enzymatic treatment of the dermis; the native architecture of the dermis was slightly disrupted. The specimens of the commercially available chemically cross-linked biomaterial PermacolTM had better mechanical properties than ADM specimens; however, there were no significant differences in terms of cytotoxicity. The state of the tissues after the explantation (number of fibroblasts and endothelial cells) showed no differences in the result of using ADM and PermacolTM. In 120 days, the materials integrated into the tissues without the formation of adhesions or inflammation. Conclusions: Our findings show that ADM does not have cytotoxic properties, has adequate biomechanical parameters to effectively reinforce supporting soft tissues, does not cause an inflammatory response during implantation, and integrates fully into tissues. Our study demonstrates the effectiveness and utility of the developed ADM in surgical treatment of anterior abdominal wall defects.

Early outcome analysis of Gastroschisis from a high-volume tertiary care institute in India: A prospective observational study

Background: Gastroschisis is one of the common congenital anterior abdominal wall defects with uncovered abdominal contents (usually intestines) protruding through it. Immediate reduction of the abdominal contents is crucial after birth because of the grave consequences of delayed management. The aim of our study was to evaluate the early outcomes of Gastroschisis at a tertiary care institute in India. Methods: This prospective observational study was undertaken over a one-year duration extending from January to December 2021 at our pediatric tertiary care teaching institute. Results: There were 30 male and 28 female patients, out of which 37 were preterm neonates. The mean birth weight was 2019±357g. Seven patients (12.07%) had major associated malformations. Fifty (86.21%) patients underwent primary skin flap closure. Staged reduction with silo was accomplished in five (8.62%) patients; three patients died during resuscitation before any therapeutic procedure could be undertaken. Among 55 (94.83%) patients with surgical procedures, only 26 (47.27%) could be salvaged with overall favorable (survival) outcomes in 44.83% of patients. Mortality was high (92.59%, 25/27) in the patients presenting with markedly edematous bowel with leathery peel. Seventeen (29.31%, 17/58) neonates died in the first 72 hours (postoperatively) due to complications of abdominal compartment syndrome, eight (13.79%) patients died due to postoperative sepsis with thrombocytopenia, and two (3.44%) had intestinal perforation. The duration of hospital stay in neonates who survived ranged from one to four weeks. Conclusion: Overall survival rates in our study were 44.83% markedly in contrast to the series published in the recent literature. The outcome of preterm (premature) patients, associated intestinal atresia, presence of edematous bowel with leathery peel, patients requiring silo due to viscero-abdominal disproportion, necrotizing enterocolitis, and associated malformations, was dismal.

A rare case of small bowel gangrene and perforation following high voltage electrical injury

This case is a 42-year-old male with an alleged history of electric shock. About 8 h after the insult, an ulcer in the right iliac fossa increased in size with fecal matter coming out. Contrast-enhanced computed tomography of the abdomen revealed a full thickness anterior abdominal wall defect with prolapse of a segment of the distal ileal loop, showing discontinuous wall and no wall enhancement suggestive of evisceration and perforation of bowel with gangrene.

Triple-layered composite mesh for managing anterior abdomen wall defects in ventral hernia

Introduction: In managing ventral hernia, using mesh for the anterior abdominal wall defect closure has become a standard. Different types of materials have been used as a mesh, each with its own benefits and drawbacks. This study aimed to investigate the potential of a triple-layered composite mesh made from amniotic membrane-coated polypropylene mesh (AMPM) with an adhesion barrier as an alternative for anterior abdominal wall defect closure. Methods: An experimental study was conducted using Sprague-Dawley mice, imposed with a mechanical ventral hernia and divided into four groups with different treatments: sham surgery, mesh polypropylene, AMPM composite, and AMPM with adhesion barrier (triple-layered composite mesh). After 7 and 30 days of the procedure, the mice were evaluated for the recurrence of anterior abdominal wall defects, the histological profile of polymorphonuclear (PMN) cells, foreign body giant cells (FBGC), fibroblast cells, neovascularization, and adhesion of mesh to surrounding tissue in each group. Results: No anterior abdominal wall defect recurrence was observed in all groups at 7- and 30-days post-procedure. We found no significant difference in histological profiles of PMN, FBGC, and fibroblast cells from each group. There was a statistically significant difference in the neovascularization (p=0.025) and adhesion (p=0.034) between the polypropylene mesh group and the triple-layered composite mesh group. Conclusion: Triple-layered composite mesh has the potential to be an alternative to cover anterior abdominal wall defects, with triple-layered composite mesh and AMPM mesh groups showing a significantly higher rate of neovascularization and a lower rate of adhesion than the polypropylene mesh group.

Impact of combined component separation technique and shoelace repair on big medline abdominal wall defect

BackgroundClosure of large anterior abdominal wall defects, regardless of their etiology, is challenging. There is no standardized information describing definitive management. Therefore, we conducted this study to illustrate our experience on large midline abdominal wall defect repair using an effective modified reconstructive technique. MethodsThis retrospective study was conducted at Al Naqib Hospital in Aden/Yemen between 2012 and 2019. Twenty-six patients with large midline abdominal wall defects of various etiologies underwent surgical repair using a combination of shoelace repair and the component separation technique. The procedure involved bilateral longitudinal division of the anterior rectus sheet and creation of a posterior layer by approximation of the medial edges of the divided rectus sheet (shoelace abdominoplasty) and anterior external oblique muscle aponeurosis separation (component separation technique) to approximate the lateral edges of the divided rectus sheet and move the rectus muscles toward the midline for constructing the anterior abdominal wall layer. The posterior and anterior layers and bilateral separated sheets were covered with a polypropylene mesh in all patients, except in those who underwent emergency damage control surgery. ResultsFour, one, and two patients developed seroma, skin necrosis and chronic pain, and post-surgical wound infection, respectively. No recurrent herniation was recorded during the median follow-up of 5 years. ConclusionThis technique is effective in restoring the integrity of the abdominal wall in large midline abdominal wall defects and has an acceptable aesthetic appearance. In our study, minimal complications were reported, and no cases of recurrent hernias were diagnosed during follow-up.

Neonatal presentation of transected sigmoid colon following umbilical cord clamping: Hernia of umbilical cord

The umbilicus is a site of numerous embryopathies involving vessels, urachus, mid gut herniation, anterior abdominal wall defects and congenital cysts. Owing to lack of awareness, umbilical cord hernia (HUC) is often misdiagnosed and underreported, with limited data in the literature. We report an isolated case of congenital HUC and perinatal transection of the sigmoid colon during cord ligature by a midwife in a local health center. A six-day old female neonate presented with discharge of fecal matter through the umbilicus. The clamped cord, became swollen and auto-amputated on day of life three, after which fecal discharge was from the stump was noted. On examination a visible bowel loop containing stool was seen in the umbilical cord. We proceeded with surgical intervention via a small umbilical incision, with findings of transection of the sigmoid colon, no peritoneal contamination, and primary anastomosis was performed. There was event free recovery postoperatively. HUC is poorly understood and often misdiagnosed as omphalocele minor. One should be cognizant of HUC when noting swelling at the base of the cord so as to avoid any inadvertent iatrogenic enterotomy by close umbilical clamping.

Beckwith-Wiedemann Syndrome and Dental Features: a Case Report

Beckwith-Wiedemann Syndrome (BWS) is characterized by a disorder on chromosome 11p15, whose loci have growth-regulating genes. Among the numerous clinical features such anterior abdominal wall defects, omphalocele and genital abnormalities, the most prevalent is macroglossia, which can lead to disturbances in craniofacial growth. This report brings a case of a 9-year-old male child with the syndrome treated at the School of Dentistry, State University of Western Paraná, Brazil. It was suggested that observed dental abnormalities, along with the commonly features described in the literature, may be a part of the broad spectrum of the syndrome.

Congenital heart defects in children with Gastro-intestinal malformations

Background. Congenital malformations of the gastrointestinal (GI) tract are common birth defects detected in the neonatal period and usually present with signs of GI obstruction which at times can be life threatening. Anorectal malformations are among the more frequent congenital anomalies. The co-occurrence of congenital heart defect (CHD) along with GI malformation can significantly affect the natural history of either defect. Purpose - to study the prevalence of GI malformations in children with CHD and study the risk factors. Materials and methods. A total 100 patients of GI malformations were enrolled out of which 66 (66%) were males and 34 (34%) were females. All patients with any GI malformations (anorectal malformation, tracheoesophageal fistulae, anterior abdominal wall defects) presenting to Neonatal Intensive Care Unit (NICU), Paediatric Cardiac unit, Pediatric and Pediatric surgery outpatient department (OPD) as well as In-patient department (IPD) between October 2019 to October 2021 were included in study. A detailed history and examination was done followed by echocardiography and the prevalence of CHD among GI malformation was observed and risk factors were studied. Results. Most common GI anomaly was anorectal malformation (71%) followed by tracheoesophageal fistula (17%), CHD was seen in 14 children. Most common heart defect was ventricular septal defect (VSD) (43%) followed by patent ductus arteriosus (PDA) (36%) and atrial septal defect (ASD) (14%). Among cases with anorectal malformation, CHDs was seen in 10% and the most common defect was VSD (43%). Forty one percent of cases with tracheoesophageal fistula had CHDs with PDA (57%) being the most common underlying defect. Functional heart defects were present in 28 children of GI malformations. Conclusions. The coexistence and severity of CHD in patients with GI malformation can have prognostic implications. Thus, early cardiac evaluation should be performed in every case of GI malformation, preferably with echocardiography. This is likely to help in the risk stratification as well as management of such children. The study was performed in accordance with the principles of the Declaration of Helsinki. Study is approved by Ethical Committee of the Institution. Informed consent of patients was obtained for the study. No conflict of interests was declared by the authors.

Outcomes of patients with exomphalos and associated congenital heart diseases

Exomphalos is an anterior abdominal wall defect resulting in herniation of contents into the umbilical cord. Severe associated chromosomal anomalies and congenital heart disease (CHD) are known to influence mortality, but it is not clear which cardiac anomalies have the greatest impact on survival. We performed a retrospective review of the treatment and outcome of patients with exomphalos over a 30-year period (1990-2020), with a focus on those with the combination of exomphalos major and major CHD (EMCHD). There were 123 patients with exomphalos identified, 59 (48%) had exomphalos major (ExoMaj) (defect > 5cm or containing liver), and 64 (52%) exomphalos minor (ExoMin). In the ExoMaj group; 17% had major CHD (10/59), M:F 28:31, 29% premature (< 37weeks, 17/59) and 14% had low birth-weight (< 2.5kg, 8/59). In the ExoMin group; 9% had major CHD (6/64), M:F 42:22, 18% premature and 10% had low birth-weight. The 5-year survival was 20% in the EMCHD group versus 90% in the ExoMaj with minor or no CHD [p < 0.0001].Deaths in the EMCHD had mainly right heart anomalies and all of them required mechanical ventilation (MV) for pulmonary hypoplasia prior to cardiac intervention. In contrast, survivors did not require mechanical ventilation prior to cardiac intervention. EMCHD is associated with high mortality. The most significant finding was high mortality in those with right heart anomalies in combination with pulmonary hypoplasia, especially if pre-intervention mechanical ventilation is required.

A staged reconstruction technique utilizing bioprosthetic mesh reinforcement in the repair of giant omphalocele

Reconstruction of complex anterior abdominal wall defects, such as giant omphaloceles, remains a reconstructive challenge for plastic and pediatric surgeons. Though several repair techniques have been described in the literature, no standardized method has been explicitly developed to treat pediatric patients. The utilization of intraabdominal tissue expanders to augment the abdominal domain has been reported as a potential repair technique. Despite its documented application, substantial controversy remains regarding tissue expander implementation due to its associated complications. We describe a staged reconstruction technique with acellular dermal matrix-assisted musculofascial reconstruction followed by delayed skin closure. Utilization of this bioprosthetic mesh in the reconstruction of anterior abdominal wall defects is well-described in the adult population. We applied the principle to a preschool-aged child with a giant omphalocele. This technique provides a medium to bolster the musculofascia, limit the formation of visceral adhesions, decrease the need for numerous procedures, and reduce the risk of infection or pulmonary compromise. This report denotes that a bioprosthetic mesh reinforcement technique may be utilized for functional reconstruction of large, complex abdominal wall malformations in the pediatric population. • What is currently known about this topic? • Giant omphalocele repair methods using tissue expansion have been described. However, these patients remain a reconstructive challenge due to high complication rates. • What new information is contained in this article? • Description of a staged reconstruction using bioprosthetic mesh musculofascial reconstruction with delayed skin closure to repair giant omphalocele in a preschool-aged child.

Patterns and Short Term Outcome of Children with Major Congenital Anterior Abdominal Wall Defects Admitted At Mbarara Regional Referral Hospital, South Western Uganda, from September 2019 to June 2020.

Background: Omphalocele and gastroschisis are the most common major congenital abdominal wall defects (CAWDs) globally. Mortality among neonates major CAWDs is higher in low-income countries than in high-income countries. This study described the patterns and short-term clinical outcomes of infants with gastroschisis and omphalocele at a regional referral hospital in southwestern Uganda.&#x0D; Methods: A case series was conducted at Mbarara Regional Referral Hospital ten months. Children born with CAWD during the study period 54 samples size were consecutively recruited into the study. Data were entered, cleaned, and analyzed using Stata version 15. Descriptive statistics were performed where continuous variables were summarized using median and interquartile ranges, while categorical variables were summarized using frequencies and proportions. Time to mortality was assessed using Kaplan–Meier survival analysis.&#x0D; Results: A total of 54 newborns were recruited into the study, of which 40 (70.04%) had Gastroschisis and 14(25.93%) had omphalocele. The median age of the infants was 9 days with an interquartile range of 4 to 21days. Of the 54 newborns, 30(69.2%) were male within the age group of 1-10 days. Mortality was higher in babies with complex gastroschisis (22) than simple gastroschisis (10). Not administering antibiotics and low birth weight were the factors associated with mortality among infants diagnosed with gastroschisis and omphalocele in the neonatal period.&#x0D; Conclusion: The most common observed defect was gastroschisis, Mortality was generally high among children presenting with gastroschisis. Complex gastroschisis has a poorer prognosis than simple gastroschisis over 30 days follow up period. Non-use of antibiotics before referral to a health facility and low birth weight were the factors associated with mortality among infants diagnosed with gastroschisis and omphalocele in the neonatal period.&#x0D; Recommendation: The most common pattern observed was Gastroschisis. The majority of children presenting with Omphalocele were more likely to survive for 30 days. There is a need for timely referral for babies born with congenital anterior abdominal wall defects.

Collagen Deposition and Inflammatory Response Associated with Macroporous Mesh Shrinkage in Incisional Hernia Repair: A Rat Model

Background: Mesh repair is the current recommendation for the treatment of incisional hernia; however, the best mesh has yet to be determined. The objective of this study was to compare the inflammatory response and collagen deposition in primary incisional hernia repair (P) and different macroporous mesh materials, including polypropylene with poliglecaprone (PP-PG), polyvinylidene fluoride (PVDF), and polyester (PE), using quantitative methods. Methods: Sixty male rats were divided into four groups. Anterior abdominal wall defects were created and either suture or mesh repair was done. Rats were euthanized on days 14, 90, and 180, and the gross findings were recorded. The inflammatory and collagen levels in the abdominal wall tissues were measured using enzyme-linked immunosorbent assay (ELISA). Results: The PE group demonstrated significant mesh shrinkage at 180 days. The extent of PE mesh shrinkage ranged from 22–42% (mean = 30.49%). At 14 days, the PVDF group had higher interleukin-6 (IL-6) levels than the PP-PG (P = .004) and PE groups (P = .019). At 90 days, the collagen type I (Col I) levels in the PE group were significantly lower than those in the others, and the collagen type I/III (Col I/III) ratios in the PE group were lower than those in the P group (P = .006). Conclusions: The persistently high IL-6 levels until 180 days and the decrease in Col I levels and Col I/III ratio at 90 days seem to predict mesh shrinkage at 180 days. The mesh induces high Col I levels, but those associated with low Col III levels should be preferred.

Cholelithiasis with epigastric hernia in down’s syndrome: a case report

Down’s syndrome is associated with various congenital anomalies, musculoskeletal abnormalities and also various anatomical variation in organ systems. In this report we are presenting a case of cholelithiasis with Epigastric hernia in 42 years Male down’s syndrome patient, on laparoscopic exploration found multiple rectus sheath defects in epigastric region and Moynihan hump. A rare case of Down’s syndrome with multiple anterior abdominal wall defects.

Acquired anterior abdominal wall defect in a neonate following umbilical catheterization: a case report

Congenital anterior abdominal wall defects are well known clinical entities. However, acquired abdominal defects are uncommon.

Our Neonatal Surgery Experiences in Somalia.

Purpose:The aim of this study is to report surgical outcomes of the neonates who have undergone various surgical procedures.Materials and Methods:In this retrospective study, 39 neonates who have undergone a surgical procedure in Mogadishu Somalia Turkey Recep Tayyip Erdoğan Training and Research Hospital, between October 2018 and March 2019 were included. Data regarding age, gender, diagnosis, surgical procedure, length of hospital stay, mortality, and cause of mortality were recorded.Results:Of 39 neonates, 12 were female (30.7%) and 27 were male (69.3%). The mean age of the neonates at admission was 7.7 ± 7.6 days (1–30 days) days. The most common diagnoses were anal atresia (n = 12, 30.8%), esophageal atresia (n = 9, 23.1%), and pyloric stenosis (n = 5, 12.8%). The most common surgical procedures were colostomy creation (n = 10, 25.6%), esophageal anastomosis (n = 9, 20.5%), primary closure of anterior abdominal wall defects including bladder exstrophy (n = 6, 15.4%), and pyloromyotomy (n = 5, 12.8%). Mortality rate was 17.9%, and mortality causes were sepsis (n = 4, 57.1%) and congenital heart disease (n = 3, 42.9%). Neonates with the highest mortality by underlying primary surgical diagnosis were esophageal atresia (n=4, 57.1%).Conclusion:The mortality rate from the surgical procedures of the neonates in Somalia is extremely high when compared with the developed countries. Employment of experienced pediatric surgeons and well-trained nurses, strict attention to the sanitary measures and shortening the time from birth to presentation might improve the surgical outcomes of the neonates in Somalia.

Comparative study between sublay (retrorectus) and onlay mesh placement in ventral hernia repair at a teaching hospital

Background: Anterior abdominal wall defects give rise to ventral hernias. Treatment modalities vary from surgical options such as open procedure, laparoscopic method to further advanced robotic surgeries. The present study aimed to find the comparison between the postoperative and short term outcomes of onlay and retrorectus (sublay) mesh placements as ventral hernia repair methods.Materials and Methods: Our enrolled ventral hernia patients were divided into two groups of 20 each. Group A underwent traditional open onlay mesh repair and group B had open sublay/retrorectus mesh hernia repair. Age, gender, body mass index, comorbidities, and past surgical history, among both groups, were comparable.Results: The duration of surgery was significantly shorter in onlay group. The sublay group was related to fewer postsurgical complications and shorter duration of drain insertion. The duration of hospital stay had no statistical significance.Conclusion: Both techniques have their pros and cons and further research is required to determine a superlative.