Introduction: Ventral hernias is major problem in surgical practice and occurs in up to 11% of patients undergoing laparotomy. Argument for the ideal surgical procedure for placing mesh continues to be unsolved. Hence there is need of study to evaluate better technique between two most commonly used methods to repair ventral hernia by two methods onlay and sublay.

Aims and Objective: To compare complications of onlay and pre-peritoneal Mesh Repair in ventral hernias.

Materials and Methods: In this study 80 patients presenting with ventral hernia between July 2015 and July 2017 in our institute are included. Randomization done as even registration no will undergo onley mesh repair and odd registration no will undergo pre-peritoneal mesh repair.

Results: Mean duration of surgery in onlay Mesh repair was 50 min and that in pre-peritoneal mesh repair was 70 min. Seroma formation was seen 4 (13.33%) patients of pre-peritoneal mesh repair and 7(23.33%) patient of onlay Mesh repair. Wound infection was seen 1(3.33%) patients of pre-peritoneal mesh repair and 5(16.67%) patient of onlay Mesh repair. Chronnic pain was seen 2(6.66%) patients of pre-peritoneal mesh repair and 6(26.87%) patient of onlay Mesh repair. Recurrence was observed only in patients with onlay mesh repair in 3 patients (10.0%) .

Conclusion: Onlay mesh repair is more associated with complication and recurrance than pre-peritoneal mesh repair. According to this study pre-peritoneal mesh repair is superior to onlay mesh repair.

1. Hershman M, Mann DV. In: Henry MM, Thompson JN, editors. Clinical Surgery. London: W.B. Saunders; 2001; 381:96.
2. Morgan EH, Anson BJ. Anatomy of region of inguinal hernia IV. The internal surface of the parietal layers. Q Bull Northwest Univ Med Sch 1942;16:20.
3. Bloom DA. Symposium: What is the best approach to the non-palpable testis? Contemp Urol 1992;4:39.
4. Bronsther B, Abrams MW, Elboim C. Inguinal hernias in children – a study of 1,000 cases and a review of the literature. J Am Med Womens Assoc 1972;27:522-5.
5. Rajput A, Gauderer MW, Hack M. Inguinal hernias in very low birth weight infants: Incidence and timing of repair. J Pediatr Surg 1992;27:1322-4.
6. Peevy KJ, Speed FA, Hoff CJ. Epidemiology of inguinal hernia in preterm neonates. Pediatrics 1986;77: 246-7.
7. Rowe MI, Clatworthy HW Jr. The other side of the pediatric inguinal hernia. Surg Clin North Am 1971;51:1371-6.
8. Scorer CG. The descent of the testis. Arch Dis Child 1964;39:605-9.
9. Cryptorchidism: An apparent substantial increase since 1960. John Radcliffe Hospital Cryptorchidism Study Group. Br Med J (Clin Res Ed) 1986;293:1401-4.
10. Fonkalsrud EW, Mengel W. The Undescended Testis. Chicago: Year Book Medical Publishers; 1981.
11. Greenall MJ, Evans M, Pollock AV. Midline or transverse laparotomy? A random controlled clinical trial. Part I: Influence on healing. Br J Surg 1980;67:188-90.
12. Bantu Rajsiddharth et al . Comparative Study of Onlay and Pre-Peritoneal Mesh Repair in the Management of Ventral Hernias. International Journal of Scientific Study 2015; 3:7
13. Carlson MA, Ludwig KA, Condon RE. Ventral hernia and other complications of 1,000 midline incisions. South Med J 1995;88:450-3.
14. Jack A. “Maingot’s Abdominal operations”, Edited by Zinner Michael J. and Schwartz Seymour I., Ellis Harold, 10th Edition, Appelton Century Crofts, 1997; 479-580.
15. Godara R, Garg P, Raj H, Singla SL. Comparative evaluation of “Sublay” versus “Onlay” meshplasty in ventral hernias. Indian J Gastroenterol 2006;25:222-3.
16. Gleysteen JJ. Mesh-reinforced ventral hernia repair: Preference for 2 techniques. Arch Surg 2009;144:740-5.
17. De Vries Reilingh TS, van Geldere D, Langenhorst B, de Jong D, van der Wilt GJ, van Goor H, et al. Repair of large midline incisional hernias with polypropylene mesh: Comparison of three operative techniques. Hernia 2004;8:56-9.

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