Open mesh repair, is still a standard technique for incisional hernia: a comparision study between sublay and onlay technique in the era of laparoscopy

Abstract

Background: Incisional hernia (IH) remains a very frequent postoperative complication and common hernias in middle aged population more commonly in females. The two techniques most frequently used are the onlay repair and sublay repair. Various studies have been conducted to compare the advantages and disadvantages of sublay and onlay mesh repair in incisional hernia and the superiority of sublay mesh repair. These studies whether they hold good for the population is a pertinent question. In view of this, author need to study the appropriate surgical techniques sublay versus onlay repair in the set up.Methods: Author conducted randomized comparative study of 100 patients having incisional hernia admitted to various surgical units of SNMC and HSK Hospital, Bagalkot during the period December 2014 to June 2016.Results: In present study of 100 cases, females have more incidence of incisional hernias than males. In onlay technique seroma formation was found in 72% of patients postoperatively and 4% in sublay technique. Surgical site infection (SSIN) was noticed in 8% of sublay technique whereas 12% in onlay technique. There is no recurrence in sublay group whereas onlay had 12% recurrence.Conclusions: Sublay technique is superior to onlay concerning the hospital stay, complications and recurrence.

A comparative study of various techniques of incisional hernia repair in a tertiary care center at Bikaner (North-West Rajasthan)

“…On comparing seroma formation in onlay and sublay group our study was concordant with the study of authors Baracs, Lamani and Dhaigude who also observed increased incidence of seroma formation in onlay group. 17,28,29 In our study incidence of wound infection was 15% in onlay group while in sublay group it was 10% similar to the study by authors. 17,28,29 In terms of recurrence rate our study is comparable to the study by Luijendijk, Baracs, Kumar, Tulaskar and Jacobus who also found increased incidence recurrence in anatomical repair group compared to mesh repair.…”

“…17,28,29 In our study incidence of wound infection was 15% in onlay group while in sublay group it was 10% similar to the study by authors. 17,28,29 In terms of recurrence rate our study is comparable to the study by Luijendijk, Baracs, Kumar, Tulaskar and Jacobus who also found increased incidence recurrence in anatomical repair group compared to mesh repair. 11,21,22,28,30 Among the mesh repair groups in our study no recurrence has been observed while Kharde and Dhaigude have found higher recurrence in onlay group compare to sublay group in 6 months follow up period.…”