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a dilated pelvis was clearly outlined, and all the calices could be seen a t the periphery. Retween pelvis and calices, however, was a large irregular filling deficiency. The accompanying reproduction of the photograph (Fig. 219) is less convincing than the original film, and it has been necessary to outline the denser parts of the shadow in order to demonstrate the deficiency. Clearly no part of the pelvis had been completely obliterated, as by a hypernephroma or carcinoma, since all the calices had been normally filled, and there was no destruction of kidney substance as by an open tuberculous lesion.The kidney was removed on March 9, 1926, and the condition was found to be as shown in the drawing (Fig. 220). The pelvis was partially filled by a diffuse villous growth, the main mass corresponding exactly to the filling deficiency seen in the skiagram. Sections showed the usual structure of a papilloma, and one from the base (Fig. 221) demonstrated that it was histologically innocent, no infiltration being found.One half of the specimen is in the museum of St. Bartholomew's Hospital ; the other is a t the Royal College of Surgeons.

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Introduction: There are many techniques to repair ventral hernia. Among these intraperitoneal onlay mesh repair has become popular. So a study on intraperitoneal onlay mesh repair is necessary to increase effectiveness of surgery, reduce the complications and reduce the cost of surgery. Aim and Objectives: To compare the outcomes of composite mesh and prolene mesh usage in intraperitoneal onlay mesh repair for ventral hernia. Methods and Materials: This prospective comparative study was conducted among the patients between 18-80 years with uncomplicated ventral hernia. 30 patients where included in the study after obtaining informed consent, with group A as 15 patients who underwent intraperitoneal onlay mesh repair for ventral hernia using composite mesh and group B as 15 patients who underwent intraperitoneal onlay mesh repair for ventral hernia using prolene mesh. Results: The mean age of patients was 45.66±11.28yrs of age, with minimum age of 30yr and maximum of 67yrs. Among them female preponderance was seen in study, with 76.7% were females and 23.3% were male patients. Duration of surgery in group A was 130±8.52mins and group B was 121.6±7.58mins. (p<0.05) The mean hospital stay among group A was 5.03±0.62days and group B was 6.0±1.1days. (p<0.05) The mean post-operative pain was significantly lower in group-A (4.4±0.51) compared to group B patients (5.53±0.52). (p<0.05) Overall 3 patients had seroma and 4 patients had the suture site infection out of 30 patients. Group B had significant higher complications compared to patients in group A. (p<0.05) Conclusion: In present study the onlay mesh repair for ventral hernia using the composite mesh was found to be superior to the prolene mesh. The mean duration of hospital stay, post operative pain and post operative complication were significantly lower among the patients underwent onlay mesh repair with composite mesh compared to the prolene mesh repair for ventral hernia.