A comparative study between onlay and sublay meshplasty in ventral hernias: a randomized controlled trial

Authors

  • Tharun Ganapathy Chitrambalam Department of General Surgery, SRM Medical College and Research Institute, Chennai, Tamil Nadu, India
  • Preetham Anguraj Department of General Surgery, SRM Medical College and Research Institute, Chennai, Tamil Nadu, India
  • Jeyakumar Sundaraj Department of General Surgery, SRM Medical College and Research Institute, Chennai, Tamil Nadu, India
  • Manimaran Pethuraj Department of General Surgery, SRM Medical College and Research Institute, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-2902.isj20191260

Keywords:

Ventral hernia, Hernia repair, Mesh repair, Meshplasty, Onlay, Sublay, Retrorectus repair

Abstract

Background: Ventral hernias are one of the most common surgical problems of the modern age. About 15-18% of all the surgical procedures performed around the world comprises of hernia repair. This study aims to compare the two common options of mesh placement in open ventral hernia repairs; over the anterior rectus sheath, the ‘Onlay meshplasty’ and in the retrorectus plane, the ‘Sublay meshplasty’.

Methods: A prospective controlled study was done between March 2017 to August 2018 on 150 patients with ventral hernia randomizing patients into 2 groups. Group A (Onlay meshplasty) and Group B (Sublay meshplasty). Duration of surgery, post-operative pain, wound infection, duration of hospital stay and recurrences were analysed with 12 months follow up.

Results: The mean duration of surgery in group A was 48.49±0.71 minutes and in group B was 72.84±0.72 minutes. Group B experienced significantly lesser pain when compared with group A. The mean asepsis score in group A was 3.60±1.09 and in group B was 0.47±0.30 with a p value of 0.006. Group A had significantly longer hospital stay (9.39 days) than group B (5.71 days). The recurrences in both the groups were statistically insignificant (Group A- 2 patients; Group B- 1 patient).

Conclusions: Sublay meshplasty although requires longer time to perform, proves to be a better alternate in terms of post-operative pain, wound infection and hospital stay.

Author Biographies

Tharun Ganapathy Chitrambalam, Department of General Surgery, SRM Medical College and Research Institute, Chennai, Tamil Nadu, India

Assistant Professor, Department of General & Minimal Access Surgery

Preetham Anguraj, Department of General Surgery, SRM Medical College and Research Institute, Chennai, Tamil Nadu, India

Post graduate, Department of General Surgery

Jeyakumar Sundaraj, Department of General Surgery, SRM Medical College and Research Institute, Chennai, Tamil Nadu, India

Professor & HOD, Department of General Surgery

Manimaran Pethuraj, Department of General Surgery, SRM Medical College and Research Institute, Chennai, Tamil Nadu, India

Post graduate, Department of General Surgery

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Published

2019-03-26

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Original Research Articles