A comparative study of on-lay and preperitoneal mesh repair in the management of umbilical hernia
DOI:
https://doi.org/10.18203/2349-2902.isj20223601Keywords:
Hernia, Mesh, On-lay, Pre-peritoneal, Repair, UmbilicalAbstract
Background: Umbilical hernias can cause distress to the patients not only because of their complications but also because of the cosmetic angle, therefore this study was undertaken mainly to study the outcomes of preperitoneal mesh repair and on-lay mesh repair in the management of umbilical hernias.
Methods: The present study was a prospective, observational and comparative study undertaken in the department of general surgery, who had been operated in Kamineni hospital LB Nagar, Hyderabad, Telangana, during a study period from November-2020 to September-2021.
Results: Of 30 patients who underwent on-lay mesh repair, the mean hospital stay was 3.83±1.8 days; wound infection, seroma, hematoma, flap necrosis was seen in 1, 4, 2, 1 respectively and with no recurrence in 6 months follow-up. Of 30 patients who underwent pre-peritoneal mesh repair, the mean hospital stay was 2.13±0.63 days; Wound infection, seroma, hematoma, flap necrosis was seen in 0, 2, 1, 0 respectively and with no recurrence in 6 months follow-up.
Conclusions: On-lay mesh repair can be replaced with preperitoneal mesh repair. Overall mesh related complications, including wound infection, seroma, hematoma, flap necrosis is quite rare. Less Hospital stay and low recurrence rate was observed in preperitoneal method. As wound complication increases risk of recurrence, procedures that do not result in formation of de-vascularizing flaps may be recommended.
Metrics
References
Jagtap M, Harbade SR, Jadhav SP. A comparative study of onlay and preperitoneal mesh repair in management of umbilical and paraumbilical hernia. New Indian J Surg. 2019;10(5):475-48.
Singh K, Dhar ML, Kamboj V. A comparative study of onlay and preperitoneal sublay mesh repair technique in umbilical hernia. Int J Res Health Allied Sci. 2019;5(2):38-42.
Venclauskas L, Jokubauskas M, Zilinskas J, Zviniene K, Kiudelis M. Long-term follow-up results of umbilical hernia repair. Videosurg Other Miniinvas Tech. 2017;12(4):350-6.
Saymour NE, Bell RL. Abdominal wall, omentum, mesentery and retroperitoneum. In: Brunicardi FC edr. Schwartz’s Principles of surgery. 10th edn. USA: McGraw-Hill Education; 2015:1449-1464.
Malangoni MA, Rosen MJ. Hernias. In: Townsend CM, Beauchamp RD, Evers MB, Mattox KL, eds. Sabiston textbook of surgery: The biological basis of modern surgical practice. 19th edn. Philadelphia: Saunders; 2012:1114-1140.
Purushotham G, Revanth K, Aiswarya M. Surgical management of umbilical and paraumbilical hernias; Int Surg J. 2017;4(8):2507-11.
Jawale PG, Chaudhari Y. Prevalence of paraumbilical hernia and outcome at surgery inpatient department: a hospital based study. MedPulse Int Med J. 2015;2(11):775.
Ali S, Mujahid MD, Javed A, Hussain MZ. Incidence of paraumbilical hernia in patients with increased BMI. Ann Punjab Med Coll. 2018;12(4).
Bessa SS, El-Gendi AM, Ghazal AH, Al-Fayoumi TA. Comparison between the short-term results of onlay and sublay mesh placement in the management of uncomplicated para-umbilical hernia: a prospective randomized study. Hernia. 2015;19(1):141-6.
SIT M, Ilgun AS, Yilmaz EE. Umbilical hernia: which technique in which defect size? Int J Health Sci Res. 2013;3(11):92-6.
Millas SG, Mesar T, Patel RJ. Chronic abdominal pain after ventral hernia due to mesh migration and erosion into the sigmoid colon from a distant site: a case report and review of literature. Hernia. 2015;19(5):849-52.
Narkhede R, Shah NM, Dalal PR, Mangukia C, Dholaria S. Postoperative mesh infection- still a concern in laparoscopic era. Indian J Surg. 2015;77(4):322-6.