Comparative Study between 'Onlay' Versus 'Retrorectus' Hernioplasty in Management of Uncomplicated Venteral Hernias

摘要

Background: Hernias of the anterior abdominal wall, or ventral hernias have a various types that can be categorized into either congenital or acquired, also can be categorized according to various locations into primary ventral hernias (true ventral- non incisional hernias) which include two subtypes lateral ventral hernia, and midline ventral hernias. Objective: The aim of the study was to compare between two techniques of mesh placement in uncomplicated ventral hernias, onlay (mesh on external oblique) versus sublay (mesh in the retromuscular space), regarding the operative technique and the postoperative complications. Patients and Methods: In this study, a comparative study between two methods of surgical treatment for ventral hernia was made. The study included 40 adult patients with uncomplicated ventral hernia divided randomly into two groups according to the surgical technique used for the repair, without any specific criteria used in selection for any technique as follows : Group A (Onlay mesh repair): Twenty patients were operated by placing the mesh above the anterior rectus sheath and the external oblique muscle. Group B (Sublay "Reteromuscular" mesh repair): Twenty patients were operated by placing the mesh in the retro- muscular space. Results: In this study no significant difference found between both methods as regarding: Age and gender, type of ventral hernia. Duration of the operative procedure. Amount of intra- operative blood loss. Postoperative hospital stay. Hernia recurrence. Conclusion: Sublay (Retromuscular) mesh repair is a good alternative to onlay mesh repairs, this study advocates this method of ventral hernia repair as it is applicable to all sites of ventral hernia, the mesh is mostly hidden and anchored behind the rectus sheath, the complication rate is low and there is a low recurrence rate and finally We suggest carrying out more trials on the retromuscular mesh repair technique to include a bigger number of cases and a longer period of follow up.