scholarly journals Comparison of Onlay versus Sublay Mesh Repair in Ventral Hernia : Our Experience in a Peripheral Hospital

2021 ◽  
Vol 24 (2) ◽  
pp. 61-65
Author(s):  
Mst Shahnaj Pervin ◽  
Hasan Shahriar Md Nuruzzaman ◽  
Eliza Sultana ◽  
Anis Uddin Ahmad
Keyword(s):  
Hospital Stay ◽  
Ventral Hernia ◽  
Mesh Repair ◽  
Operative Time ◽  
Controlled Trial ◽  
Standard Procedure ◽  
Sublay Repair ◽  
Sublay Mesh ◽  
Repair Group ◽  
Onlay Repair

Background: Mesh repair is the standard procedure of choice for the ventral hernia repair. The common techniques for this surgery are onlay and sublay repair. But the superior technique between the two is yet to be established objectives. Objectives: We conducted this study to compare the results of Onlay with Sublay mesh repair for the treatment of ventral hernia. Methods: This comparative study was conducted at the department of Surgery, Shaheed Tajuddin Ahmad Medical College Hospital, Gazipur from April 2018 to April 2019. 20 patients withclinically diagnosed ventral hernia were randomized into two groups. The patients in group A had onlay mesh repair while those of group B hadsublay mesh repair. Comparison between the two methods were made in terms of operative time, technical ease, early post operative events specially drain & complication, hospital stay, recurrence. Result: Twenty patients between 20 to 70 years of age among whom 6 are male and 14 are female with different types of ventral hernia including paraumbilical, umbilical, epigastric and incisional, except with defect more than 15 cm were studied. The sublay repair took significantly longer operative time (p = .023). Onlay repair group had more seroma formation, wound infection and recurrence, though not statistically significant. Patients who underwent sublay repair had early removal of drains (3.7 ± .823 days vs 6 ± .738 days) which was significant (p= .000). At the same time sublay repair group had significantly shorter hospital stay than the onlay group (4.5 ± 1.900 days vs 6 ± 1.354 days, p= .023). Conclusion: Sublay repair seems to be a better alternative than onlay repair of Ventral hernia. Randomised controlled trial with larger case numbers is needed to validate the result. Journal of Surgical Sciences (2020) Vol. 24 (2) : 61-65

scholarly journals Evaluation of retro muscular mesh repair technique for treatment of ventral hernia

2018 ◽  
Vol 5 (2) ◽  
pp. 364
Author(s):  
Mohammad M. Alkhayat ◽  
Hatem A. Saleh ◽  
Mohammed N. Shaker ◽  
Mohammed Abd-El-Galil El-Balshy
Keyword(s):  
Ventral Hernia ◽  
Mesh Repair ◽  
Operative Time ◽  
Incisional Hernia Repair ◽  
Repair Technique ◽  
Male Patients ◽  
The Mean ◽  
Optimal Approach ◽  
Sublay Mesh

Ventral hernias commonly encountered in surgical practice account for 15-20% of all abdominal wall hernias. Results of tissue repair have been disappointing. The optimal approach for abdominal incisional hernias is still under discussion. The aim of the study was to evaluate the retro muscular mesh repair technique in the treatment of ventral hernia as one of the standard techniques for treatment of such cases. This prospective study on 50 consecutive patients was performed from July 2016 to July 2017. Patients were prepared to be operated by the retro muscular mesh repair technique. All patients were evaluated with respect to operative time and postoperative complications. Results were documented and statistically analysed. In this study on 50 patients, there were 30 female patients (60%) and 20 male patients (40%). The age of the studied patients ranged between 26 and 65 years with mean age of 49.8 years. The mean operative time was 88.5±15.3 min. The mean period of drainage was 2.3±1.3 days. Seroma was encountered in one case only 2%. No recurrence was reported in the studied patients during the period of follow-up (12months). On the basis of this study, we conclude that retro muscular (sublay) mesh repair is the ideal technique for incisional hernia repair.

scholarly journals Onlay versus sublay mesh repair for ventral hernia

2018 ◽  
Vol 5 (3) ◽  
pp. 823
Author(s):  
Raghuveer M. N. ◽  
Suraj Muralidhar ◽  
Harshavardhan Shetty ◽  
Veena V.
Keyword(s):  
Hernia Repair ◽  
Hospital Stay ◽  
Wound Infection ◽  
Ventral Hernia ◽  
Mesh Repair ◽  
Ventral Hernia Repair ◽  
Operating Time ◽  
Ethical Review ◽  
Lower Complication ◽  
Sublay Mesh

Background: Ventral hernia repair is one of the most common surgical operations performed all over the world. Onlay and sublay mesh repairs are the commonly performed techniques for the same. However, the debate still continues about the superiority of both techniques over each other. The aim of this study was to compare the outcome of the onlay versus sublay mesh repair for ventral hernia.Methods: A total of 100 patients with paraumbilical, epigastric, supraumbilical and incisional hernias (with defect size ≤4 inches) were divided into main two groups; A: onlay mesh repair and B: sublay mesh repair. Patients with uncontrolled diabetes and recurrent ventral hernia were excluded. Randomization was done using computer generated software. Patients were evaluated for operating time, postoperative seroma formation, wound infection, drain duration, post-op hospital stay and recurrence of symptoms. Ethical approval for this study was granted by the ethical review committee of Mysore Medical College, Mysore, Karnataka, India.Results: The incidence of post-operative seroma and wound infection was 6.52% and 4.35% in sublay group compared to 21.30% and 19.20% in onlay group which was statistically significant (p<0.05). Mean operating time was found to be more in sublay group than onlay group which was also statistically significant (72.3+9.23 vs. 65.25+10.58 minutes, p<0.05). Mean drainage duration (4.22+0.99 days vs. 5.97+1.24 days) and post-op hospital stay (4.8+1.51 days vs. 6.68+1.46 days) was low in sublay group compared to onlay group which was statistically significant (p<0.05). Recurrence in sublay group was 4.35% compared to 8.51% in onlay group which was not statistically significant (p>0.05).Conclusions: Even though operating time is longer, placement of mesh in sublay position is a better option than onlay placement in open ventral hernia repair because of lower complication rate and post-op morbidity.

scholarly journals Laparoscopic repair of umbilical and paraumbilical hernias: a prospective and interventional study in government hospital

2019 ◽  
Vol 6 (9) ◽  
pp. 3283
Author(s):  
Kiren B. Patel ◽  
Mithun V. Barot
Keyword(s):  
Surgical Site Infection ◽  
Hospital Stay ◽  
Wound Infection ◽  
Ventral Hernia ◽  
Laparoscopic Repair ◽  
Umbilical Hernia ◽  
Operative Time ◽  
Postoperative Hospital Stay ◽  
Site Infection ◽  
Drain Removal

Background: Umbilical and ventral hernia occurs as a result of weakness in musculofascial layer of anterior abdominal wall. The most important causes are congenital, acquired, incisional and traumatic. UH and VH can be repair by open surgical procedure. A successful series of laparoscopic repair of umbilical hernia and VH was done by Le blanc in 1993. The cost can be optimised by selection of mesh and optimal uses of transabdominal suture and various fixation devices. This original article reveals methods, techniques, indication, contraindication, post-op pain, operative time, surgical site infection recurrence and outcome of laparoscopic umbilical hernia and paraumbilical hernia repair.Methods: A total of 21 patients of ventral hernia (umbilical, paraumbilical and incisional), who underwent laparoscopic hernia repair from October 2014 to October 2016, were selected have taken part in study with valid consent, in B.J. Medical College Ahmedabad Gujarat. All patient study regarding operative time, postoperative pain, postoperative hospital stay, surgical site infection like wound infection, seroma, hernia defect size, mean drain removal and recurrence.Results: Out of 21 patients male are 33% and female are 67%. Mean age of patients is 45 yrs with range being 18-65 yrs. 28%, 33.33%, and 38.1% of patient had umbilical, paraumbilical and incisional hernia respectively. Mean size defect was 7.8 cm2. Mean operative time in this study is 98.6 minute. Mean drain removal is 2.80 day. Mean postoperative hospital stay was 3.3 days. 4.7% had wound infection, 9.5% had seroma formation. There is 0% recurrence in present study.Conclusions: The laparoscopic approach appears to be safe, effective and acceptable. It is also effective in those who are obese, with co morbidities (complex) and who have recurrence from prior open repair and having ascites.

scholarly journals Onlay and sublay mesh repair in incisional hernias: our experience from GSL medical college and hospital, Rajahmundry

2021 ◽  
Author(s):  
Kovvuri Ramananda Reddy ◽  
Bikkina Gopala Krishna ◽  
Anant A. Takalkar
Keyword(s):  
Mesh Repair ◽  
Postoperative Recurrence ◽  
Operative Techniques ◽  
Optimal Method ◽  
Medical College ◽  
Operative Complications ◽  
Deep Surgical Site Infection ◽  
Onlay Mesh ◽  
Sublay Repair ◽  
Sublay Mesh

Background: The incidence of post-operative wound infection and wound-related complications due to mesh repair aimed at continuing research into the optimal method of treatment of these hernias. The two operative techniques most frequently used in case of ventral hernia are the onlay and sublay repair. However, it remains unclear which technique is superior. Objectives were to compare the morbidity and complications associated with onlay and sublay mesh repair in the management of incisional hernias.Methods: The present descriptive observational study was carried out in patients admitted in surgical wards at GSL medical college and hospital, Rajahmundry who are clinically diagnosed to have incisional hernia. The study was carried out from January to November 2019. Data was analysed with SPSS 23.0.Results: Seroma was seen in 12% and 8% respectively from onlay and sublay group and this proportion of seroma was more in onlay group as compared to sublay group (<0.05). Postoperative recurrence of hernia was seen in both groups equally. Number of days of hospitalization in sublay group was less as compared to onlay group. Deep surgical site infection (SSI) was seen in 8% and 4% respectively from onlay and sublay group.Conclusions: Sublay mesh repair has a lower rate of post-operative complications than onlay mesh repair, deep SSI leading to infection of mesh is higher in on‑lay mesh repair. Number of days of hospitalization in sublay group was less as compared to onlay group.

scholarly journals A comparative study of on-lay and sub-lay mesh repair of ventral wall hernias in a tertiary health care centre

2018 ◽  
Vol 5 (10) ◽  
pp. 3386
Author(s):  
Dharmendra B. L. ◽  
Vijaykumar N.
Keyword(s):  
Ventral Hernia ◽  
Mesh Repair ◽  
Wide Spectrum ◽  
Surgical Techniques ◽  
Study Groups ◽  
Suction Drainage ◽  
Health Care Centre ◽  
Mesh Placement ◽  
Surgical Department ◽  
Sublay Mesh

Background: Ventral hernia is a common occurrence in abdominal surgeries and an important source of morbidity. A wide spectrum of surgical techniques have been developed, ranging from suturing techniques to various types of prosthetic mesh repair. Use of mesh repair technique showed a reduced number of postoperative complications and recurrence compared with other techniques. The exact technique of mesh repair is still debated. The purpose of this study was to compare the traditional on‑lay mesh and sublay mesh placement in ventral hernia repairs in terms of time taken for surgery, duration of drainage after surgery, early complication and delayed complications.Methods: This is a prospective study which was conducted in the surgical department of our hospital. A total of 50 cases were included in this study. Of these cases, 25 cases were operated by the on‑lay mesh method and 25 by sublay mesh placement.Results: The operative time for sublay mesh placement was significantly higher than that of on‑lay mesh repair, whereas, the duration of post-operative suction drainage was significantly lower in case of the sublay group. Occurrence of complications like superficial surgical site infection and seroma formation were statistically insignificant in both the study groups, although frequency of complications was lesser in the sublay group. The recurrence rate was found to be 12% in on‑lay mesh repair and 8%in sublay(retro‑rectus) mesh repair.Conclusions: Sublay mesh repair is a better method than onlay repair with respect to the duration of the post-operative suction drainage. A lower rate of complications and a lower rate of recurrence was seen in the sublay mesh repair group.

scholarly journals LAPAROSCOPIC APPENDECTOMY;

2019 ◽  
Vol 26 (01) ◽  
Author(s):  
Sajid Malik ◽  
Kamran Zaib Khan ◽  
Iftikhar Ahmad
Keyword(s):  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Standard Procedure ◽  
Minimal Invasive ◽  
Time Duration ◽  
Duration Of Hospital Stay ◽  
Post Operative Pain ◽  
Scar Mark ◽  
Almost All

Background: Minimal invasive surgery (MIS) is a modern and safe improvement in field of laparoscopic surgery. Single incision laparoscopic appendectomy (SILA) is a major breakthrough in MIS and has become standard procedure for acute appendicitis in place of conventional three port laparoscopic appendectomy (CTLA). Objectives: To see the potential advantages in terms of operative time, duration of hospital stay, post-operative pain and cosmetic results in SILA and CTLA groups. Study Design: Randomized control study. Setting: Department of General Surgery in Allama Iqbal Medical College/ Jinnah Hospital Lahore. Period: July 2016 to June 2017. Materials and Methods: 48 patients were divided in two groups; group SILA (cases) and CTLA (control). Each group comprised 24 patients. All cases were performed by consultant who were competent enough and trained in MIS. Results: We found that there was statistically no difference in operative time (p>0.05) and post-operative pain (p>0.05) of both procedures but statistically significant outcome was observed in duration of hospital stay (p<0.005) and cosmetic result (p< 0.005). Post-operative analgesia usage was same in both groups with similar outcome of control. Surgical wound healed in all patients of both groups without complication but noticeably had shown no scar mark on three months follow up in patients of SILA group. Almost all patients in SILA group were discharged on same day on oral diet. Conclusion: This study showed that results of SILA are better in terms of cosmoses and less duration of hospital stay in the presence of non-significant operative time of two procedures. Staying with promise of minimizing in MIS to SILA, cosmetic satisfaction and minimal hospital stay are its comprehensible advantages.

scholarly journals A RETROSPECTIVE COMPARATIVE STUDY OF PREPERITONEAL VS ONLAY MESH REPAIR IN CASES OF VENTRAL HERNIAAT TERTIARY CARE INSTITUTE

2019 ◽  
pp. 1-3
Author(s):  
Manubhai V. Pipalia
Keyword(s):  
Ventral Hernia ◽  
Mesh Repair ◽  
Operative Time ◽  
Tertiary Care ◽  
Clinical History ◽  
Onlay Mesh ◽  
Retrospective Comparative Study ◽  
Operative Findings ◽  
Complications Rate ◽  
Preoperative Examination

Background: A ventral hernia is an abnormal protrusion of intra abdominal or preperitoneal content through the anterior abdominal wall fascia and muscle defect. Hernioplasty with prosthetic mesh is surgical treatment modality for all types of ventral hernia.There are various anatomic planes where mesh can be put. This study was planned to compare preperitoneal repair and onlay mesh repair in terms regarding their outcome. Methods: This is a retrospective study with total number of 112 cases of ventral hernia with prosthetic meshplasty was done. In all cases clinical history, preoperative examination findings, intraoperative and post operative findings were noted. All data was categorised according to where mesh was put intra-operatively in anatomical plane of preperitoneal or onlay. Statistical analysis of all data was done and outcome was measured. Results: Mean operative time was less in onlay hernioplasty than preperitoneal hernioplasty but over all complications were high in onlay hernioplasty.Preperitoneal hernioplasty method had lowest complications rate. Conclusions: Preperitoneal hernioplasty is better choice than onlay hernioplasty. AIM:To assess the better method from onlay meshplasty and preperitoneal meshplasty in cases of ventral hernia. OBJECTIVE: To compare the both methods on the bases of operative time ,speed of postoperative period recovery, and postoperative complications.

scholarly journals Polymeric clips are a quicker and cheaper alternative to endoscopic ligatures for securing the appendiceal stump during laparoscopic appendicectomy

2018 ◽  
Vol 100 (6) ◽  
pp. 454-458 ◽  
Author(s):  
MSJ Wilson ◽  
P Maniam ◽  
A Ibrahim ◽  
N Makaram ◽  
SR Knight ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Hospital Stay ◽  
Body Mass ◽  
Operative Time ◽  
Controlled Trial ◽  
Operating Time ◽  
Antibiotic Use ◽  
Laparoscopic Appendicectomy ◽  
Duration Of Surgery ◽  
Appendiceal Stump

Introduction The use of polymeric clips in securing the appendiceal stump has been increasingly reported as a viable alternative to current methods in emergency laparoscopic appendicectomy. We evaluated the operative outcomes following the use of polymeric clips versus endoscopic ligatures. The primary endpoint was operative time, with secondary outcomes including complications, inpatient stay, and cost analysis. Materials and methods Operative records were retrospectively analysed to identify patients undergoing laparoscopic appendicectomy between January 2014 and June 2015. Data collected included age, gender, body mass index, duration of surgery, length of hospital stay, antibiotic use, preoperative haematological and biochemical parameters, 30-day readmission rate and complications. Results A total of 125 patients were included within the study, with 78 within the endoloop group and 47 in the polymeric clip group. There were no differences in age, gender, body mass index, hospital stay, antibiotic use, 30-day readmission rates or postoperative complications. Operative time was significantly reduced in the polymeric clip group (59 vs. 68 minutes, P = 0.00751). The use of polymeric clips cost £21 compared with £49 for endoloops per operation, which rose to £70 if both clips and endoloops were used during the procedure. Discussion Polymeric clips are a safe, viable and economical method for securing the appendiceal stump during laparoscopic appendicectomy. The clinical significance of nine minutes of reduced operating time in the polymeric clip cohort warrants further study with an adequately powered randomised controlled trial.

scholarly journals MESH REPAIR

2016 ◽  
Vol 23 (07) ◽  
pp. 840-843
Author(s):  
Muhammad Paryal Tagar ◽  
Khawar Saeed Jamali ◽  
Muhammad Jawed ◽  
Sarang Tagar
Keyword(s):  
Mesh Repair ◽  
Tertiary Care ◽  
Chronic Obstructive ◽  
Care Hospital ◽  
Obstructive Pulmonary Disease ◽  
Surgical Department ◽  
Hospital Patients ◽  
End Stage ◽  
Sublay Mesh ◽  
Repair Group

Objectives: Compare the complications of inlay versus sublay mesh repairin epigastric hernia. Study Design: Observational study. Setting: Surgical department ofmultiple hospitals and compares the results, JPMC, Civil Hospital Karachi and NaushahroFeroze. Period: March 2015 to February 2016. Methodology: 94 patients presenting withupper abdomen midline swellings aged between 25 to 60 years attended as outdoor patientat a tertiary care hospital. Patients associated with chronic obstructive pulmonary disease likeasthma, abdominal malignancies and cirrhosis with end stage liver disease, multiple hernia,patients with prior hernia repair with mesh and defects < 4cm were excluded. Results: Outof the 94 patients, the majority was found to be male. 61 (64.89%) males and 33 (35.10%)females. Mean age was found to be 41.57+4.54 years. Inlay mesh repair group observed highcomplications as compared to sublay mesh repair group. Wound Infection observed 4(8.5%) cases inlay mesh repair group and 2(4.25%) cases in sublay mesh repair group. SeromaInfection observed 3(6.38 %) cases inlay mesh repair group and 1(2.12 %) cases in sublay meshrepair group. Recurrence occurred inlay mesh repair group was observed in 2(4.25%) cases.Short Hospital stay was observed in sublay mesh repair group. Conclusion: We concludethat sublay mesh repair is a better alternative to only mesh repair for all forms of ventral herniacases.

Sign in / Sign up

Export Citation Format

Share Document