COMPARATIVE STUDY OF SUBLAY OVER ONLAY MESH FIXATION IN INCISIONAL HERNIA OF ANTERIOR ABDOMINAL WALL
Abstract
Background: Ventral hernia after abdominal surgery is a common complication. Several techniques for the repair of hernia of anterior abdominal wall have been described from time to time and it is a great challenge for a surgeon. The mesh placement by sublay technique authorized by Rives and Stoppa in Europe has been reported to be effective with low recurrence rate. Objective: The objective of this study was to evaluate the efficacy of sublay technique over the onlay mesh fixation in hernia of anterior abdominal wall. Methodology: This prospective study was conducted over a period of two years from January 2014 to December 2015. A total of 50 patients with hernia of anterior abdominal wall were included in this study. The patients were divided as group I (onlay mesh fixation) and group II (sublay mesh fixation). Data collected in data collection sheet regarding demographic data, severity of symptoms and post operative complains of patients which were then analyzed. Result: Total 50 patients were included in our study. Age ranged from 21-60 years. Male were 17(34%) and female were 33(66%). Post-operative complication was seroma 26 (52%), wound infection 18(36%) and no wound dehiscence in sublay mesh fixation. The 22(88%) patients in group II stay less than 5 days in hospital. While 19(76%) patients of group I was discharged from hospital >5th postoperative day. Conclusion: Sublay mesh repair in ventral hernia was found to be a better and effective technique with minimal complication rate.
Downloads
References
Malik AM. Laparoscopic versus open repair of para-umbilical hernia. It is good alternative. Pak J Med Assoc 2015; 65:865-8.
Breuing K, Butler CE, Ferzoco S, Franz M, Hultman CS, Kilbridge JF, et al. Incisional ventral hernias: Review of the literature and recommendations regarding the grading and technique of repair. Surgery 2010; 148:544-58.
Kuzbari R, Worseg AP, Tairych G, Deutinger M, Kuderna C, Metz V et al., Sliding door technique for the repair of midline incisional hernias. Plast Reconstr Surg. 1998; 101:1235–1242.
Machairas A, Misiakos EP, Liakakos T, Karatzas G., Inci sional hernioplasty with extraperitoneal onlay polyester mesh. Am Surg. 2004; 70(8):726–729.
San Pio JR, Damsgaard TE, Momsen D, Villadsen I, Larsen J., Repair of giant incisional hernias with polypropylene mesh: a retrospective study. Scand J Plast Reconstr Surg Hand Surg. 2003; 37:102–10.
Shell DH, de La Turre J, Anradis P, Vesconez OI. Open repair of ventral incisional hernia. Surg Clinc North Am 2008; 83:1233-4.
Kaya B, Uçtum Y, Eris C, Bat O, Ziyade S, Kutanis R. The surgical results of onlay mesh repair for incisional hernia. J Clin Anal Med 2012; 3:425-8.
Leithy M, Loulah M, Greida HA, Baker FA, Hayes AM. Sublay hernioplasty versus onlay hernioplasty in incisional hernia in diabetic patients. Menoufia Med J. 2014; 27: 353-8.
Mehmud A. Tension free mesh hernioplasty: a review of 96 cases. JPMI 2004; 18: 46-51.
Buclenall TE, Cox PJ, Ellish H. Burst abdomen and incisional hernia: A prospective study of 1129 major laparotomies. Br. Med J 1982; 284: 931-3.
Shell DH, Torre JDL, Andrades P, Vasconez LO. Open repair of ventral hernia incisions. Surg Clin North Am. 2008; 88:61-83.
El-Santawy HMG, El-Sisy El-Azeem AA, El-Gammal AS, El-Kased AF, Sultan HM. Evaluation of retromuscular mesh repair technique for treatment of ventral incisional hernia. Menoufia Med J. 2014; 27:226-9.
Oh T, Hollands MJ, Langcake ME, Parasyn AD. Incisional hernia repair: a Retrospective review and early experience of laparoscopic repair. Surgery 2004; 74:50-6.
Hameed F, Ahmed B, Ahmed A, Dab RH, Dilawaiz. Incisional hernia repair by preperitoneal (sublay) mesh implantation. A. P.M.C 2009 ; 3 : 27-31.
Rajsiddhartha et al. A comparative sudy of onlay and pre-peritoneal mesh repair in the management of ventral hernias. International Journal of Scientific Study. 2015; 3: 122-8.
Gleysteen JJ. Mesh reinforced ventral hernia repair: Preference for 2 techniques. Arch Surg 2009; 144: 740 5.
Ibrahim AH, El-Gammal AS, Heikal MMM. Comparative study between 'onlay' and 'sublay' hernioplasty in the treatment of uncomplicated ventral hernia. Menoufia Med J 2015; 28:11-6.
