Evaluation of the Sublay Mesh Repair Outcomes in Different Types of Ventral Hernia

Abstract

Introduction: Ventral hernia repair is one of the challenging surgical operations over time. Several surgical techniques for mesh repair have been described (onlay, inlay, sublay, and underlay repairs). It is suggested that sublay mesh repair has the lowest recurrence and surgical site infection in open anterior abdominal hernia repair. This study aimed to analyze the pros and cons of the sublay mesh in ventral hernia repair to evaluate the significance of this technique as a treatment modality. Hospital stay, acute postoperative complications, and the recurrence rate were the main areas of investigation.Methods: A retrospective study on 79 patients with ventral hernias who were operated on with sublay mesh repair between January 2015 and December 2018 was conducted. Patients were admitted through the elective route. The study included fit patients with first-time ventral hernias (primary and incisional). Recurrent hernia, patients with decompensated cardiopulmonary disorders, and bleeding disorders were excluded from the project. The project pro forma includes patient's demographics, operative details, length of stay, postoperative complications, and follow-up up to 12 months.Results: All patients underwent open mesh repair using the sublay technique. The ventral hernia was five times more common in females than males. The mean age of presentation was 44.8 years old. The mean operating time was 67 minutes and a one-day hospital stay. Paraumblical and incisional hernias represented the majority of cases. The component separation approach was added in three cases (3.7%). Simultaneous cholecystectomy was performed in two cases (2.5%). Only six cases (6.3%) developed wound-related complications, while two cases (2.5%) had a recurrence. Conclusion:The sublay mesh repair is a perfect choice for the repair of ventral abdominal hernia. It is associated with a smooth and short hospital stay and the least incidence of complications and recurrence.

Demographics and outcomes of ventral wall hernia repair at Sultan Qaboos University Hospital

“…However, it was found in a previous study that was done in the United Kingdom that the umbilical hernia was the commonest followed epigastric, and incisional hernias. 8 Thus, was consistent with regional report which concluded para umbilical hernia as the most common. 1,10 In addition, there was no statistically significant correlation between the type of hernia and duration of hospital stay, nor outcomes.…”

“…6 However, previous data from studies done in Egypt (5:1) are comparable to ours. 8 This might correlate to the variation of environmental and genetic factors in Arab population when compared to western community. Nevertheless, the analysis showed that the mean BMI of our study 32.3 kg/m 2 and hospital stay post operatively which was 3.5 days was approximately similar to the reported data internationally 27 kg/m 2 and a hospital stay of 3 days.…”

A Comparative Study of Elective Sublay Versus Onlay Repair for Non-complex, Small, and Medium-Size Incisional Hernia: Post-operative Complications in a Tertiary Hospital in Ranchi, India

“…Due to the low incidence of recurrence shown by mesh hernioplasty, it is considered a standard operation for incisional hernia as it provides a tension-free closure of the defect and increases the tensile strength of the wound [ 1 , 9 , 14 ]. Mesh repair works on the principle of Laplace’s law by distributing the pressure across the mesh [ 8 ]. The anatomical position of the mesh is an important aspect in the development of complications in the early post-operative recovery period and the development of recurrence [ 4 ].…”

“…Apart from the technique used for previous operations and wound infections, associated factors like obesity, smoking, and chronic medical conditions like diabetes and COPD all lead to the formation of incisional hernias [6][7][8].…”

The Benefit of Open Rives-Stoppa Procedure in Complex Incisional Hernia.

“…[6,7] f prosthetic mesh implants has been shown to decrease the incidence of recurrence by 8%tive techniques for incisional hernia repair use only subway (intramuscular or extra fascial) traperitoneal or subfascial). [8] On multiple treatment analyses, retro-rectus was ranked as placement option with a high probability of being the best treatment. [9] pair (Rives-Stoppa) had a 94.2% probability of having the lowest odds for recurrence and a ility of having the lowest odds for surgical site infection (SSI).…”