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Journal articles on the topic 'Onlay Mesh'

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Published: 7 June 2025

Last updated: 16 July 2025

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Yang, George Pei Cheung. "From intraperitoneal onlay mesh repair to preperitoneal onlay mesh repair." Asian Journal of Endoscopic Surgery 10, no. 2 (2017): 119–27. http://dx.doi.org/10.1111/ases.12388.

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Pross, M., J. B??ttger, and H. Lippert. "Intraperitoneal Onlay Mesh Placement With ePTFE-mesh." Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 16, no. 6 (2006): 447. http://dx.doi.org/10.1097/00129689-200612000-00017.

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Sanjeev, Kumar. "Onlay and Sublay Mesh Repair in Incisional Hernias: Randomized Comparative Study." International Journal of Pharmaceutical and Clinical Research 13, no. 5 (2021): 518–23. https://doi.org/10.5281/zenodo.14226419.

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Aim: The study of Onlay and Sublay mesh repair in incisional hernias. Methods: This was a randomized comparative study conducted in the Department of Surgery, Madhubani Medical College and Hospital, Madhubani, Bihar, India, for 12 months. Clinically diagnosed as incisional hernia were included in this study. Total 100 cases were studied during the above said scheduled period. The patients were randomly divided into two groups. Group A (Onlay mesh) and Group B (sublay mesh) repair carried out. Results: Out of 100 subjects from onlay group, majority were from 31-40 years age group. i.e., 21 (42%) whereas in sublay group 27 i.e., 54% were from 31-40 years age group. In both group majority were from same age group. Proportion of males were 64% and 58% in onlay and sublay group respectively. Proportion of females were 36% and 42% in onlay and sublay group respectively. Postoperative complication like seroma was seen in 14% and 10% respectively from onlay and sublay group. This proportion of seroma was more in onlay group as compared to sublay group (<0.05). Postoperative complication like deep SSI was seen in 10% and 6% respectively from onlay and sublay group. This proportion of deep SSI was almost equal in both the groups (p>0.05). Postoperative recurrence of hernia was seen in both groups equally i.e., 3 case in each group (p>0.05). Mean days of hospitalization in onlay group was 8.52±1.8 days whereas in sublay group it was 0.071±1.35 days. Difference in mean days of hospitalization between both groups was found to be highly significant (p<0.001). It means number of days of hospitalization in sublay group was less as compared to onlay group. Conclusion: Sublay mesh repair has a lower rate of post-operative complications than onlay mesh repair, although larger studies are required to choose the better of the two procedures.

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Kulkarni, Narendra D., Geet Adhikari, and Gauri S. Jadhav. "An observational study to compare the outcomes of onlay technique with combined onlay-plug technique of mesh hernioplasty in inguinal hernia." International Surgery Journal 9, no. 3 (2022): 567. http://dx.doi.org/10.18203/2349-2902.isj20220396.

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Background: Inguinal Hernia is a common entity in general surgical practices across the world. Its management though appears to be straightforward, could still be a nightmare for a surgeon if not dealt with proper attention and care. Lichtenstein’s mesh hernioplasty is still one of the most popular surgeries performed for inguinal hernia repair across the world. At our institute, we commonly perform this surgery with either Onlay mesh hernioplasty technique or combined Onlay-Plug mesh technique. The double mesh placement had always kept us engaged in regards to its post-operative outcomes and its advantage over single onlay mesh. We were also keen to take the subject due to the scarce availability of the recent literature.Methods: This prospective observational study was conducted in the Department of Surgery, Dr. Hedgewar Hospital, Aurangabad, Maharashtra, India on 200 patients who were randomly and equally divided into two groups. Patients in Group A underwent Onlay mesh hernioplasty surgery, while patients in Group B underwent combined Onlay-Plug mesh hernioplasty surgery. Post-operative outcomes were assessed in both groups for a period of six months.Results: There was a significant difference between the two groups in terms of post-operative pain, scrotal edema, cord tenderness, and wound infection as patients in Group 2 who underwent combined Onlay-Plug mesh repair were found to have more incidences of the above-mentioned post-operative outcomes.Conclusions: Single Onlay mesh placement is sufficient. There is no significant benefit of keeping an additional Plug/Inlay mesh in patients undergoing tension-free mesh inguinal hernioplasty as per our findings.

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Amid, Parviz K., Esbern Friis, Gunter Horeyseck, and Matthias Kux. "Tension-free onlay mesh hernioplasty." Operative Techniques in General Surgery 1, no. 2 (1999): 156–68. http://dx.doi.org/10.1016/s1524-153x(99)80018-9.

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Kapoor, Kanu, Paritosh Gupta, Dhruv Kundra, AmanPriya Khanna, Chinmay Arora, and Aakanksha Agarwal. "Laparoscopic intraperitoneal onlay mesh repair (intraperitoneal onlay mesh plus) in 429 patients – Our experience." International Journal of Abdominal Wall and Hernia Surgery 3, no. 4 (2020): 144. http://dx.doi.org/10.4103/ijawhs.ijawhs_19_20.

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Lammers, B. J., S. Voos, M. Witt, and P. E. Goretzki. "Ergebnisse der konventionellen «Mesh»-augmentierten Narbenhernien-Chirurgie – intraperitoneale Onlay-Mesh-, Onlay- und Sublay-Techniken." Visceral Medicine 19, no. 2 (2003): 24–28. http://dx.doi.org/10.1159/000076184.

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Samee, Muhammad Umair, Muhammad Furqan Sharif, Hafiz Muhammad Abdullah Tahir, Mirza Zeeshan Sikandar, Fahad Ahmad Khan, and Hassan Ashfaq. "Comparison between Sublay & Onlay Mesh hernioplasty in Ventral Wall Abdominal Hernia Repair." Pakistan Journal of Medical and Health Sciences 17, no. 5 (2023): 189–91. http://dx.doi.org/10.53350/pjmhs2023175189.

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Background & Aim: Onlay and sublay repairs are the two surgical methods most commonly employed in ventral hernia patients. The repair of a ventral hernia is one of the most common surgical procedures performed globally. The results of simple ventral hernia onlay and sublay mesh repair methods were compared in this study to compare the results of onlay and sublay mesh ventral incisional hernia repair procedures. To investigate the frequency of seroma, wound infection, and wound disruption in patients with ventral abdominal hernias who had onlay and sublay mesh plasty. Incisional hernia (IH) is a very common surgical complication. Study design: Prospective Randomized Control Trial Place and duration of study: This study was done in department of General surgery at Central Park teaching Hospital, Lahore during a period of 4 months that span from October 2021 till January 2022. Methodology: This prospective research included 100 adults with primary or secondary uncomplicated ventral hernias. The onlay mesh repair procedure was used in both groups B (n = 50) and A (n = 50). We randomly assigned participants to one of two therapy groups using a computer-generated randomization process. The procedure's length, the length of the drain, the duration of any wound infections, the length of the post-op hospital stay, and any short-term recurrence were all noted. Results: When compared to the sublay group, the onlay group had a substantially shorter median operational time (52 vs. 91 min., respectively). However, in terms of wound complications and postoperative pain, the sublay group beat the control group significantly. Disease recurrence occurred in 8% and 3% of patients in groups A and B, respectively. Practical Implication: Sublay mesh repair, which is an alternative to onlay mesh repair, can be used to treat all types of ventral hernias. Conclusion: Sublay mesh repair, which is an alternative to onlay mesh repair, can be used to treat all types of ventral hernias. Mesh-related issues are associated with long drainage times, seroma development, wound infection, and recurrence. In terms of postoperative discomfort and wound complications, sublay mesh repair is preferred than onlay mesh repair for treating incisional hernias. The recurrence rates of the two procedures are comparable. Keywords: Ventral Hernia, Onlay Mesh Repair, Sublay Mesh Repair

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Kancharla, Srinivas Rao, Venkataharish Nimmagadda, and Praneeth Bobba. "Sublay mesh versus Onlay mesh: a randomized comparative study." Journal of Clinical and Investigative Surgery 7, no. 1 (2022): 13–19. http://dx.doi.org/10.25083/2559.5555/7.1.3.

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Introduction. Ventral hernias are the second most common hernia; Onlay and Sublay operating techniques are procedures commonly performed in such cases. There is no consensus on the superiority of these procedures. The aim of this study was to compare the results of both procedures in order to identify the recommended technique between the two options. Materials and Methods. A total of 106 patients with epigastric, umbilical, paraumbilical, incisional hernias were studied. These patients were grouped into group A (onlay) and Group B (sublay). The outcomes of the two techniques were compared with respect to operative time, pain, hospital stay, seroma, infection, recurrence and patient satisfaction. Results. The mean operative time was 81.30 minutes in group A, and 85.85minutes in group B. Twenty-two (42.5%) patients in group A and seven (12.96%) patients in group B developed seroma. Nine (17.3%) patients in group A, 3 (5.55%) patients in group B developed post-operative infection. 30 (57.69%) patients in group A and 47(87.3%) patients in group B reported moderate pain, whereas three (5.76 %) and seven (12.96%) patients in group A and group B were reported severe pain in immediate post-operative period. At 48 hours, 20 (38.46%) and 24 (44.44%) of patients in group A and B were reported moderate pain, whereas 32 (61.53%) and 30 (55.55%) patients in group A and B reported mild pain. The mean hospital stay was 10.11 days in group A and 6.22 in group B. Three (5.76 %) patients of group A has recurrence, none of the patients in sublay group has developed recurrence. Thirty-nine (72.22%) patients of sublay group expressed their satisfaction but only 20(38.46%) patients in onlay group expressed their satisfaction. Conclusion. With reference to all the study parameters except one, the sub lay technique of mesh placement appears to be better. The exception is pain in the immediate postoperative period.

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Deepak, Kumar Sah, and Shekhar Sudhanshu. "Comparative Analysis of Onlay vs. Preperitoneal Mesh Repair in Hernia Surgery: An Observational Study." International Journal of Pharmaceutical and Clinical Research 15, no. 12 (2023): 1983–87. https://doi.org/10.5281/zenodo.11210510.

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Both incisional and spontaneous ventral hernias following abdominal surgery are considered to be part of the anterior abdominal wall. Pre-peritoneal or onlay mesh repair is possible. The use of either type of meshplasty is controversial because of variations in the simplicity of conducting the procedure, the duration of the surgery, challenges that develop in the recovery phase following surgery, as well as the procedure’s return. Preoperative evaluation of 60 patients who presented with ventral hernias included clinical assessment and ultrasound to confirm the diagnosis. Following approval and fulfilment of the inclusion and exclusion criteria, onlay and pre-peritoneal mesh repairs were performed on 34 and 26 patients, respectively. In the pre-peritoneal mesh repair group, seroma formation, wound infection, and mesh infection were observed in 8.8%, 8.8%, and 2.9% of patients, respectively, and in 19.2%, 15.33%, and 7.6% of patients in the onlay mesh repair group. Of the patients in the onlay group, 11.53% experienced recurrence. The pre-peritoneal mesh repair group did not experience any recurrences. The onlay group also had a higher morbidity rate related to associate factors. Recurrent links were found between seroma development, infection, and chronic pain in onlay mesh repair and pre-peritoneal mesh repair. When a ventral hernia is repaired with an onlay mesh, there is an increased chance of recurrence, especially in patients who also have co-morbid diseases such as multiparity, obesity, or diabetes. We concluded that pre-peritoneal repair is better than onlay repair after analyzing all of these data.    

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Shani Aoda, Furat, and Alaa Sharif Ibrahim. "Sublay versus onlay mesh repair of ventral hernia." AL-QADISIYAH MEDICAL JOURNAL 9, no. 16 (2017): 208–16. http://dx.doi.org/10.28922/qmj.2013.9.16.208-216.

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Ventral hernias are commonly encountered in surgical practice. The estimated incidence of ventral hernia is 15-20%. Although a wide variety of surgical procedures have been adopted for the repair of incisional hernia, but the implantation of prosthetic mesh remains the most efficient method of dealing with ventral hernia. Our study is to evaluate the technique of preperitoneal (sublay) mesh repair of ventral hernias and compare it to onlay mesh repair. The prospective study was carried out in 102 patients of incisional and paraumblical hernia.52 patients were managed by onlay mesh repair and 50 patients were managed by sublay mesh repair.Observation in both groups were made with regards to duration and ease of operation, placement and duration of drainage, woundcomplications, hospital stay, and recurrence. Follow up every three month for 12-24 months was done . In onlay group drain was removed after 2-5 days except one patient with large incisional hernia drain was removed after 14 days .In sublay group drain was removed after 2-3 days. Post operative complications like seroma & wound infection were comparable in both groups. In sublay group Seroma formation was 2%(one patient only) . Wound infection was2% (one patient only).No septic mesh was removed in the series. In onlay group seroma formation was24%(12 patients) most of seroma occur in large incisional hernias repair, wound infection was 4% (2 patient s)and one septic mesh was removed. In sublay recurrence rate was 0%,in onlay recurrence rate was 2%(one patient).ConclusionSub lay mesh repair is associated with less chances of seroma formation and almost no recurrence with low post operative complication like infection and wound edge necrosis.

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Cano-Valderrama, Oscar, JosÉ L. Porrero, Esther Quirós, et al. "Is Onlay Polypropylene Mesh Repair an Available Option for Incisional Hernia Repair? A Retrospective Cohort Study." American Surgeon 85, no. 2 (2019): 183–87. http://dx.doi.org/10.1177/000313481908500226.

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Lately, incisional hernia repair (IHR) with onlay polypropylene mesh has been replaced by other surgical procedures. The aim of this study was to compare the complication and recurrence rate after onlay mesh repair and other surgical procedures for IHR. A retrospective cohort study of patients who underwent IHR in a single center was conducted. The data were obtained from electronic medical records. Patients who had been lost during follow-up were contacted for a visit in the clinic. Univariate and multivariate analysis was performed with Stata 13.0 to analyze the factors associated with postoperative complications and hernia recurrence. Between June 2004 and December 2015, 1078 patients underwent IHR in a single center. Onlay mesh repair was performed in 125 patients (11.6%). Other surgical procedures included Rives procedure (29.3%), sublay mesh repair (38.6%), intrabdominal mesh repair (17.1%), and primary closure (3.4%). After a mean follow-up of 2.8 years, 73 (7%) patients developed a recurrence. A higher percentage of complications were seen after onlay mesh repair than after other surgical procedures (22.4% vs 13.1%, P = 0.005). Nevertheless, recurrence was less frequent after onlay mesh repair (4.2% vs 7.1%, P = 0.241). Logistic regression discarded an association between onlay mesh repair and hernia recurrence or postoperative complications. Incisional hernia repair with onlay polypropylene mesh repair was not associated with a higher incidence of postoperative complications or recurrence rate. So, this procedure should not be discarded in selected patients presenting with incisional hernia.

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Hasan, Yasir, Sajid Al-Helfy, and Riaydh Jabur. "Is Sublay Mesh Repair for Incisional Hernia Better Than Conventional Onlay Mesh Repair?" Iraqi Journal of Medical Sciences 18, no. 2 (2020): 138–44. http://dx.doi.org/10.22578/ijms.18.2.8.

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Background: Incisional hernia (IH) after abdominal surgery is a well-known complication and its incidence continues to be 10-15% after laparotomy. The repair of IH has always been a challenge to the surgeon. Various operative techniques for the repair of IH are in practice; however, the management is not standardized. The sublay technique has been reported to be quite effective, with low recurrence rates and minimal complications. Objective: To assess the advantage and complications of sublay mesh repair of IH in comparison to onlay mesh repair. Methods: Prospective study of 63 patients undergoing repair of IH from 1st January 2013 to 1st February 2015 done in General Surgical Unit of Al-Imamein Al-kadhmein Medical City. 42 cases of IH were managed by onlay mesh repair and 21 cases of IH were managed by sublay mesh repair. Results: Post-operative complications like seroma and wound infection were comparable in both groups. In sublay group seroma formation was one patient (4.76%). Wound infection was in one patient (4.76%). No septic mesh was removed in the series. In onlay group, seroma formation was in 9 patients (21.42%); most of seroma occur in large IH repair, wound infection was in 2 patients (4.76%) and one septic mesh was removed. In sublay recurrence rate was 0%, in onlay recurrence rate was in one patient (4.76%). Conclusion: Sublay mesh although it is more time consuming and technically more difficult, however, it carries low recurrence rate and few postoperative wound complication. Keywords: Sublay, onlay, Mesh Repair, Incisional Hernia Citation: Hasan YA, Al-Helfy SHA, Jabur RT. Is sublay mesh repair for incisional hernia better than conventional onlay mesh repair? Iraqi JMS. 2020; 18(2): 138-144. doi: 10.22578/IJMS.18.2.8.

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Nahabedian, M. Y. "Diastasis recti repair with onlay mesh." Hernia 25, no. 4 (2021): 855–62. http://dx.doi.org/10.1007/s10029-021-02464-y.

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Yang, Xue-Fei, and Jia-Lin Liu. "Laparoscopic intraperitoneal onlay mesh (IPOM) repair." ASVIDE 3 (October 2016): 403. http://dx.doi.org/10.21037/asvide.2016.403.

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N., Raghuveer M., Suraj Muralidhar, Harshavardhan Shetty, and Veena V. "Onlay versus sublay mesh repair for ventral hernia." International Surgery Journal 5, no. 3 (2018): 823. http://dx.doi.org/10.18203/2349-2902.isj20180432.

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Background: Ventral hernia repair is one of the most common surgical operations performed all over the world. Onlay and sublay mesh repairs are the commonly performed techniques for the same. However, the debate still continues about the superiority of both techniques over each other. The aim of this study was to compare the outcome of the onlay versus sublay mesh repair for ventral hernia.Methods: A total of 100 patients with paraumbilical, epigastric, supraumbilical and incisional hernias (with defect size ≤4 inches) were divided into main two groups; A: onlay mesh repair and B: sublay mesh repair. Patients with uncontrolled diabetes and recurrent ventral hernia were excluded. Randomization was done using computer generated software. Patients were evaluated for operating time, postoperative seroma formation, wound infection, drain duration, post-op hospital stay and recurrence of symptoms. Ethical approval for this study was granted by the ethical review committee of Mysore Medical College, Mysore, Karnataka, India.Results: The incidence of post-operative seroma and wound infection was 6.52% and 4.35% in sublay group compared to 21.30% and 19.20% in onlay group which was statistically significant (p<0.05). Mean operating time was found to be more in sublay group than onlay group which was also statistically significant (72.3+9.23 vs. 65.25+10.58 minutes, p<0.05). Mean drainage duration (4.22+0.99 days vs. 5.97+1.24 days) and post-op hospital stay (4.8+1.51 days vs. 6.68+1.46 days) was low in sublay group compared to onlay group which was statistically significant (p<0.05). Recurrence in sublay group was 4.35% compared to 8.51% in onlay group which was not statistically significant (p>0.05).Conclusions: Even though operating time is longer, placement of mesh in sublay position is a better option than onlay placement in open ventral hernia repair because of lower complication rate and post-op morbidity.

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Venkatarangaiah, Ranganath M., Darshan A. Manjunath, Amarnath V. Mudda, and Veerabhadra Radhakrishna. "Retromuscular prefascial mesh placement versus onlay mesh placement in the repair of incisional hernias: a prospective study." International Surgery Journal 5, no. 1 (2017): 120. http://dx.doi.org/10.18203/2349-2902.isj20175552.

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Background: An incisional hernia is a common complication of abdominal surgery with an incidence rate of two to 11%. Although there are various techniques described, the mesh repair has been the gold standard in the elective management of incisional hernias. But the best method of mesh placement is still debatable. Hence a study was conducted to compare the Retromuscular prefascial mesh placement with Onlay mesh placement in the treatment of incisional hernias.Methods: A prospective study was conducted in the Department of General Surgery in a tertiary center from November 2010 to May 2012. All patients with an incisional hernia underwent either Retromuscular prefascial mesh repair or onlay mesh repair. The nature of the previous surgery, size of the defect, operative, and postoperative complications were recorded. Mann Whitney test and Fisher’s exact test was used to evaluate the significance of the difference. A ‘p’ value <0.05 was considered significant.Results: A total of 60 patients were studied with 30 patients each in the Retromuscular prefascial group and the onlay group. Forty (67%) cases of incisional hernia were secondary to lower midline incision and hysterectomy was the most common surgery [30 patients (50%)]. The Retromuscular prefascial mesh group had significantly lesser postoperative complications (2/30 vs. 12/30; p=0.002; Fischer’s exact test) and seroma formation (1/30 vs. 8/30; p=0.02; Fischer’s exact test) compared to the onlay mesh group.Conclusions: Retromuscular prefascial mesh repair was equally effective but associated with fewer complications compared to onlay mesh repair.

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Reddy, Kovvuri Ramananda, Bikkina Gopala Krishna, and Anant A. Takalkar. "Onlay and sublay mesh repair in incisional hernias: our experience from GSL medical college and hospital, Rajahmundry." International Surgery Journal 8, no. 9 (2021): 2607. http://dx.doi.org/10.18203/2349-2902.isj20213183.

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Background: The incidence of post-operative wound infection and wound-related complications due to mesh repair aimed at continuing research into the optimal method of treatment of these hernias. The two operative techniques most frequently used in case of ventral hernia are the onlay and sublay repair. However, it remains unclear which technique is superior. Objectives were to compare the morbidity and complications associated with onlay and sublay mesh repair in the management of incisional hernias.Methods: The present descriptive observational study was carried out in patients admitted in surgical wards at GSL medical college and hospital, Rajahmundry who are clinically diagnosed to have incisional hernia. The study was carried out from January to November 2019. Data was analysed with SPSS 23.0.Results: Seroma was seen in 12% and 8% respectively from onlay and sublay group and this proportion of seroma was more in onlay group as compared to sublay group (<0.05). Postoperative recurrence of hernia was seen in both groups equally. Number of days of hospitalization in sublay group was less as compared to onlay group. Deep surgical site infection (SSI) was seen in 8% and 4% respectively from onlay and sublay group.Conclusions: Sublay mesh repair has a lower rate of post-operative complications than onlay mesh repair, deep SSI leading to infection of mesh is higher in on‑lay mesh repair. Number of days of hospitalization in sublay group was less as compared to onlay group.

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Siddha, Narayan Gole, and Soni Surbhi. "A Comparative Study of Retro Rectus and Onlay Mesh Repair by Open Surgical Technique in Ventral Hernias." International Journal of Pharmaceutical and Clinical Research 16, no. 11 (2024): 252–56. https://doi.org/10.5281/zenodo.14250368.

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Background: Ventral hernia repair is a commonly performed surgical procedure with over a million cases annually in India. Traditional suture repair methods have high recurrence rates, especially in larger hernias. The advent of synthetic mesh has revolutionized hernia repair, significantly reducing recurrence. However, the optimal placement of the mesh—whether onlay or retrorectus (sublay)—remains debated. This study aims to compare the outcomes of onlay and retrorectus mesh repair in patients undergoing ventral hernia repair by open surgical technique. Materials and Methods: A prospective comparative study was conducted from May 2023 to May 2024 at Dr. Bhim Rao Ambedkar Memorial Hospital and District Hospital in Raipur, enrolling 60 patients diagnosed with ventral hernias. Patients were divided into two groups: Group A (onlay mesh repair) and Group B (retrorectus mesh repair), with 30 patients each. Intraoperative and postoperative variables, including surgical duration, complications (seroma, surgical site infections), and hospital stay, were recorded. Data were analyzed using SPSS version 20.0, applying unpaired t-tests, Chi-square, and Fisher’s exact tests as appropriate. Results: The mean age of participants was 45.87 years. Group A (onlay) had a significantly higher rate of seroma formation (20% vs. 4% in Group B, p<0.05) and surgical site infections (16% vs. 4% in Group B, p<0.05). The mean hospital stay was longer for the onlay group at 5 days compared to 4 days for the retrorectus group (p<0.0002). Additionally, drain duration was prolonged in the onlay group due to increased seroma formation, suggesting greater postoperative morbidity associated with this technique. Conclusion: Retrorectus mesh repair offers advantages over the onlay approach, showing lower rates of complications, shorter hospital stays, and reduced drain duration. These findings support the retrorectus technique as a preferred method for ventral hernia repair, providing better outcomes with lower morbidity.

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Fitzgibbons, Robert J. "Intraperitoneal Onlay Mesh Technique for Laparoscopic Herniorrhaphy." Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 4, no. 5 (1994): 408. http://dx.doi.org/10.1097/00019509-199410000-00058.

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Nguyen, N. X., J. Camps, and RobertJ Fitzgibbons. "Laparoscopic Intraperitoneal Onlay Mesh Inguinal Hernia Repair." Surgical Innovation 1, no. 2 (1994): 106–15. http://dx.doi.org/10.1177/155335069400100205.

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A, Ravi Kamal Kumar, Chandrakumar S V P L, Vijayalaxmi A, Thokala Sivaiah, and Venkat Ramana N. "INCISIONAL HERNIA - ONLAY VS SUBLAY MESH HERNIOPLASTY." Journal of Evolution of Medical and Dental Sciences 4, no. 35 (2015): 6040–45. http://dx.doi.org/10.14260/jemds/2015/880.

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Machairas, Anastasios, Evangelos P. Misiakos, Theodore Liakakos, and Gabriel Karatzas. "Incisional Hernioplasty with Extraperitoneal Onlay Polyester Mesh." American Surgeon 70, no. 8 (2004): 726–29. http://dx.doi.org/10.1177/000313480407000814.

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Recurrent incisional hernia remains a major problem for the general surgeon. The high recurrence rate of incisional hernias after primary closure by tissue approximation led to the development of tension-free procedures using prosthetic materials. The goal of this study is to present the results of an extraperitoneal tension-free technique using a polyester mesh (Mersilene). A total of 43 patients with incisional hernias were surgically treated during a 9-year period in our department. Twenty-four patients (56%) had recurrent incisional hernias, 21 had primary repair by tissue approximation, and 3 had prolene mesh tension-free repair with wound infection. Patients’ mean age was 68.2 years, and the mean postoperative follow-up was 54.4 months. Immediate postoperative complications were noticed in 9 patients (21%) subcutaneous seroma in 6 (14%) and wound infection in 3 (7%). Recurrence was noticed in 4 patients (9%) during the first 9 postoperative months. Late minor complications such as restriction of abdominal wall motility and chronic pain was noticed in 3 (7%) patients. In conclusion, the extraperitoneal onlay tension-free incisional hernia repair using polyester mesh is an easy and safe procedure with no major morbidity or recurrence rate.

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Gopalakrishnan, Dr G. "Intraperitoneal Onlay Mesh Repair (IPOM) versus Intraperitoneal Onlay Mesh Repair with Closure of Fascia Defect (IPOM Plus) for Ventral Hernias: Retrospective Analysis of Postoperative Outcomes." Journal of Medical Science and clinical Research 12, no. 08 (2024): 08–13. http://dx.doi.org/10.18535/jmscr/v12i08.02.

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Background: Intra-peritoneal onlay mesh (IPOM) repair, a type of Laparoscopic Ventral Hernia Repair (LVHR), comprises bridging the defect from the peritoneal side with a composite mesh. Recently, IPOMPlus has become the recommended type of LVHR in which the defect in the fascia is sutured before placing the mesh. Materials and Methods: This study is a retrospective cohort study conducted at Dharan Hospital, Salem. Patients who had undergone IPOM-Plus or IPOM during January 2020 to June 2021 were selected. Data regarding demographics, intra-operative and post-operative outcomes were collected from medical record section. Patients were followed up for 6 months. Data analysis was performed using SPSS version 26.0 taking a p-value of <0.05 as statistically significant. Results: A total of 74 patients were included in this study, out of which 34 patients had undergone IPOM (Group A) and 40 patients underwent IPOM-Plus (Group B). In both the groups, there was no statistical difference in demographic variables except more number of umbilical hernia in both the groups compared to epigastric and paraumbilical hernia. Hernia defect size and mean operative time were varied significantly (p-value < 0.05) in both groups. More number of seroma formation (p=0.021), pseudosac at first OPD visit (p=0.020) and pseudosac at 6 months (p=0.027) in Group A compared to Group B. Conclusions: IPOM plus repair is safe with possible advantages over a standard IPOM repair in patients with ventral hernia in term of postoperative outcomes. Keywords: Ventral hernia, IPOM, IPOM Plus, Laparoscopy

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Zinther, N. B., P. Wara, and H. Friis-Andersen. "Shrinkage of intraperitoneal onlay mesh in sheep: coated polyester mesh versus covered polypropylene mesh." Hernia 14, no. 6 (2010): 611–15. http://dx.doi.org/10.1007/s10029-010-0682-z.

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Rakesh, Rawat, Porwal Varsha, and Ghulyani Tuhin. "A Comparative Study of Onlay versus Retrorectus Mesh Placement in Incisional Hernia Repair." International Journal of Current Pharmaceutical Review and Research 15, no. 09 (2023): 516–19. https://doi.org/10.5281/zenodo.12635768.

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Background: The incisional hernias are an iatrogenic complication, which has always been a challenge to thesurgeons with respect to complications & recurrences. Various surgical techniques are in practice with datasupporting the placement of retro‑rectus mesh repair over onlay mesh repair.Aims & Objectives: To evaluate & compare the efficacy of onlay mesh repair and retrorectus mesh placementfor repair of incisional hernia.Material & Methods: In this prospective study 60 recruited patients with midline hernias up to 10 cm in diameter,who were admitted to the General surgery department of our tertiary care hospital from November 2021 till August2023. The socio-demographic details & complete history taken & investigations carried out. Patients wererandomized into two groups. Group A – patients who had undergone traditional on‑lay mesh repair (n=30); GroupB - included patients who had undergone retro‑rectus mesh repair (n=30). Patients underwent either traditionalon‑lay mesh repair or retro‑rectus mesh repair according to their groups. Surgery was completed in both groups.Parameters recorded were operating time, postoperative pain scores at 2, 5, and 7 days, Complications, and woundinfection if present. Sutures were removed on the 14th post‑operative day & patients were discharged on the 15thpost‑operative day if no complications were present. Follows were scheduled at 1 month, 3 months & 6 months.Results: The operative time was more for Group A patients as compared to Group B (p<0.05). In Group A, thepostoperative pain scores on days 2, 5 & 7 were 7.21±0.57, 5.33±0.85 & 2.31±0.75. For Group B, thepostoperative pain scores on days 2, 5 & 7 were 6.26±0.28, 4.06±0.339 & 1.42±0.84. The post-operative painscores showed statistically significant higher values for Group A patients than for Group B(p<0.05). Thecomplications in Group A were seroma, deep surgical site infection, mesh removal & recurrence which werestatistically significantly higher than Group B(p<0.05).Conclusion: Retrorectus Mesh Repair is a technique-sensitive procedure with the advantage of reducing therecurrence rate and surgical site infection as compared to onlay mesh repair.

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Faizan Muhammad, Muhammad Irshad Hussain, Syed Muhammad Saud Ali Bokhari, et al. "Comparison between Onlay vs Sublay Mesh Techniques in Terms of Wound Infection, Seroma Formation and Recurrence-A Retrospective Study." Indus Journal of Bioscience Research 3, no. 1 (2025): 570–74. https://doi.org/10.70749/ijbr.v3i1.550.

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Introduction: Ventral hernia repair remains a significant challenge, with onlay and sublay mesh techniques being widely used. This study evaluates these approaches in terms of wound infection, seroma formation, recurrence, and skin necrosis. Objectives: To compare the outcomes of onlay and sublay mesh repair techniques in ventral hernia surgery. Materials and Methods: A retrospective cross-sectional study was conducted at Recep Tayyip Erdogan Hospital, Muzaffargarh, reviewing 123 patients who underwent elective mesh hernioplasty from January 2017 to December 2021. Data on demographics, comorbidities, hernia type, procedure type, operative time, and complications were analyzed. Results: Onlay repair was performed in 59.3% and sublay in 40.7% of cases. Seroma formation was higher in sublay (18%) than onlay (10%). Recurrence occurred only in the onlay group (2.86%). SSI rates were 4.3% for onlay and 0% for sublay. Operative time was longer for sublay repairs. Conclusion: We concluded in ths study that both the techniques are effective with comparable outcomes. Sublay repairs reduce recurrence but require longer operative times.

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Kim, Trudy S., Dharshan Sivaraj, Devi Lakhlani, et al. "Ventral Hernia Repair With Onlay Placement of Biosynthetic Ovine Rumen Is Noninferior to Retrorectus Placement." Plastic and Reconstructive Surgery - Global Open 13, no. 4 (2025): e6666. https://doi.org/10.1097/gox.0000000000006666.

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Background: Mesh placement impacts postoperative outcomes in ventral hernia repair (VHR). The retrorectus technique is associated with lower recurrence rates than the onlay technique. Hybrid meshes, combining synthetic and biologic benefits, have been introduced, but the effect of placement location on outcomes remains unclear. Methods: We retrospectively analyzed 71 patients who underwent VHR with biosynthetic ovine rumen in either an onlay (n = 38) or retrorectus (n = 33) position. We compared demographics, comorbidities, complications, and recurrent rates. Multivariate logistic regression assessed associations between mesh placement and outcomes. Results: Onlay patients were older (mean 62.9 versus 57.4 y, P = 0.03) and had larger hernias (158 versus 73.8 cm2, P < 0.001). Most patients had grade 2 or 1 hernias according to the modified ventral hernia working group classification, with no significant differences in postoperative complications. Hernia recurrence occurred in 5.41% of onlay patients and 0% of retrorectus patients. Conclusions: No significant differences in complications or recurrence rates were observed between placement techniques. These findings suggest that hybrid mesh placement in an onlay position is a safe and durable strategy for VHR.

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Singh, Bhal, Mahender Kumar Jalthania, and Santosh Kumari. "A comparative study of various techniques of incisional hernia repair in a tertiary care center at Bikaner (North-West Rajasthan)." International Surgery Journal 6, no. 8 (2019): 2909. http://dx.doi.org/10.18203/2349-2902.isj20193341.

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Background: Incisional hernia can be defined as an internal abdominal wall defect that develops after a previously closed laparotomy. Aim of present study was to compare open suture repair and mesh repair (onlay and sublay), various factors predisposing to incisional hernia and evaluate complications following surgery for incisional hernias.Methods: A prospective study was conducted in 60 cases of incisional hernia admitted in Department of General Surgery, PBM Hospital Bikaner between October 2017 to September 2018. 20 cases were selected in each group (open anatomical repair, onlay mesh repair and sublay mesh repair). All cases were followed up for 6 months postoperatively.Results: Incisional hernia was found to occur more often in 41-60 years age group (61.67%) and in females. Wound infection (46.67%) after index surgery was most important risk factor followed by obesity. LSCS (30%) was found to be most common index surgery followed by hysterectomy (28.33%). Seroma was most common postoperative complication (5% patient in anatomical repair group, 30% patients in onlay group and 10% patients in sublay group).Only one recurrence (5%) was observed in anatomical repair group over a period of 6 months follow up.Conclusions: Sublay mesh repair is superior to onlay mesh repair and Anatomical suture repair regarding recurrence rate. Local postoperative complications like seroma formation or wound infection were more common in mesh repair surgery than anatomical repair. Among mesh repair these complications were higher in onlay group than sublay repair.

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Khurram Zia, Muhammad, Sarmad Younis, Aqeel Ashraf, Shahid Khan Afridi, Fazli Subhan, and Muhammad Attique Sadiq. "Compare the Efficacy and Safety between Onlay Versus Sublay Mesh Repair for Para-Umbilical Hernia." Pakistan Journal of Medical and Health Sciences 16, no. 1 (2022): 1112–14. http://dx.doi.org/10.53350/pjmhs221611112.

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Objective: To compare the efficacy and safety between onlay mesh technique and sublay mesh technique in patients undergoing paraumbilical hernia repair. Study Design: Retrospective/Observational Place & Duration: In the department of surgery, Muhammad Teaching Hospital, Peshawar and Fauji Foundation Hospital, Rawalpindi and conducted during the period from March 2021 to August 2021. Methods: A total of 166 patients with both genders having ages 18 to 65 years who were undergoing para-umbilical hernia repair were included. Patients demographic including age, gender were recorded after informed consent. Patients were equally divided into two groups Group O and Group S. Group O (83 patients) received onlay mesh technique and Group S (83 patients) received sublay technique. Outcomes such as post-operative pain, wound infection, seroma formation and hospital stay were recorded and compare the results between both groups. Results: In group O 48 (57.83%) patients and in group S 47 (56.63%) patients were females while 35 (42.17%) and 36 (43.37%) patients were males in group O and S. There was significant difference in term of post-operative pain 6.01+2.26 vs 3.58+1.44 (P-value <0.05). In group O 14 (16.87%) patients and in group S 4 (4.82%) patients had wound infection. 8 (9.64%) patients in Group O and 2 (2.40%) patients in Group S had seroma. Mean Hospital stay in days was high in Group O compared to Group B 5.32+1.74 vs 2.46+1.38 days (p=<0.05). There was a statistical significant difference regarding efficacy between both procedures with p-value 0.036. Conclusion: We concluded that sublay mesh technique for para-umbilical hernia repair was safe and effective with very low rate of complications as compared to onlay mesh procedure. Keywords: Paraumbilical Hernia Repair, Onlay Mesh Technique, Sublay Mesh Technique, Outcomes.

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Stoikes, Nathaniel, David Webb, Ben Powell, and Guy Voeller. "Preliminary Report of a Sutureless Onlay Technique for Incisional Hernia Repair Using Fibrin Glue Alone for Mesh Fixation." American Surgeon 79, no. 11 (2013): 1177–80. http://dx.doi.org/10.1177/000313481307901121.

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The Rives repair for ventral/incisional (V/I) hernias involves sublay mesh placement requiring retrorectus dissection and transfascial stitches. Chevrel described a repair by onlaying mesh after a unique primary fascial closure. Although Chevrel fixated mesh to the anterior fascia with sutures, he used fibrin glue for fascial closure reinforcement. We describe an onlay technique with mesh fixated to the anterior fascia solely with fibrin glue without suture fixation. From January 2010 to January 2012, 50 patients underwent a V/I hernia onlay technique with fibrin glue mesh fixation. Records were reviewed for technical details, demographics, mesh characteristics, and postoperative outcomes. Primary fascial closure with interrupted permanent suture was done with or without myofascial advancement flaps. Onlay polypropylene mesh was placed providing 8 cm of overlap. Fibrin glue was applied over the prosthesis and subcutaneous drains were placed. Mean age was 62.4 years. Mean body mass index was 30.1 kg/m2. Average mesh size was 14.5 cm 3 19.1 cm. Mean operative time was 144.4 minutes (range, 38 to 316 minutes). Mean discharge was postoperative Day 2.9 (range, 0 to 15 days). Morbidity included eight seromas, one hematoma, and three wound infections. Seventeen patients required components separation. Mean follow-up was 19.5 months with no recurrences. This is the first series describing fibrin glue alone for mesh fixation for V/I hernia repair. It allows for immediate prosthesis fixation to the anterior fascia. Early results are promising. Potential advantages include less operative time, less technical difficulty, and less long-term pain. A prospective trial is needed to evaluate this approach.

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Atnasious, MarkM, MostafaA E. Abd El-Aziz, AhmedM Ali, and MahmoudR Shehata. "Repair of large incisional hernias with onlay mesh." Journal of Current Medical Research and Practice 3, no. 3 (2018): 130. http://dx.doi.org/10.4103/jcmrp.jcmrp_121_18.

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Khan, Dr Rafat, and Dr Kulwant Singh. "Study of incisional hernia with onlay mesh repair." Surgical Update: International Journal of Surgery and Orthopedics 6, no. 3 (2020): 173–80. http://dx.doi.org/10.17511/ijoso.2020.i03.06.

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Saber, Aly. "Onlay versus Sublay Mesh Repair for Ventral Hernia." Journal of Surgery 4, no. 1 (2016): 1. http://dx.doi.org/10.11648/j.js.s.2016040101.11.

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Nitu, Bharti, and Rajak Baidyanath. "A Comparative Analysis of Onlay versus Pre-Peritoneal Mesh Repair in Incisional Hernia Treatment." International Journal of Pharmaceutical and Clinical Research 16, no. 6 (2024): 2534–38. https://doi.org/10.5281/zenodo.13851919.

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Background: Incisional hernias are a frequent complication following abdominal surgery, with significant implications for patient outcomes and healthcare resources. The optimal surgical technique for repair remains debated, particularly between onlay and pre-peritoneal mesh placement, both of which are widely used but have distinct advantages and limitations. Aim: This study aims to compare the efficacy, safety, and postoperative outcomes of onlay versus pre-peritoneal mesh repair in the treatment of incisional hernias. Methods: A prospective observational study was conducted with 100 patients diagnosed with incisional hernia. Participants were randomly assigned to undergo either onlay mesh repair (Group A, n=50) or pre-peritoneal mesh repair (Group B, n=50). Data were collected on intraoperative variables, postoperative recovery, complications, and hernia recurrence. Statistical analysis was performed using SPSS version 23.0, with significance set at p<0.05. Results: Pre-peritoneal mesh repair was associated with longer surgery duration (89.6 ± 18.3 minutes vs. 75.4 ± 15.2 minutes, p=0.001) and greater blood loss (170.6 ± 52.3 mL vs. 150.2 ± 45.8 mL, p=0.045). However, it resulted in significantly less postoperative pain (VAS score: 3.8 ± 1.5 vs. 4.5 ± 1.3, p=0.021) and shorter hospital stays (4.4 ± 1.3 days vs. 3.6 ± 1.2 days, p=0.003). Complication rates were lower in the pre-peritoneal group, though not statistically significant, with fewer wound infections and seroma formations. Hernia recurrence was also lower in the pre-peritoneal group (2% vs. 8%), although this difference did not reach statistical significance (p=0.148). Conclusion: Pre-peritoneal mesh repair, despite requiring more surgical time and blood loss, offers superior postoperative outcomes compared to onlay mesh repair, with less pain, quicker recovery, and lower, though not statistically significant, hernia recurrence. These findings suggest that pre-peritoneal repair may be the preferred technique for incisional hernia treatment. Recommendations: Surgeons should consider patient-specific factors when selecting the repair technique, favoring pre-peritoneal mesh placement, particularly for patients at higher risk of postoperative complications. Further research is recommended to solidify these findings through randomized controlled trials.

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Tiwari, SK, and Pawanindra Lal. "A rare case of acute intestinal obstruction due to bowel entrapment in migrated onlay polypropylene mesh." Annals of The Royal College of Surgeons of England 96, no. 7 (2014): e4-e5. http://dx.doi.org/10.1308/003588414x13946184900200.

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Onlay mesh hernioplasty is the gold standard technique in the management of inguinal hernias. We report a rare case of intraperitoneal mesh migration with bowel entrapment causing acute intestinal obstruction in an elderly patient.

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Havrylov, H. O., O. V. Shulyarenko, and M. O. Yosypenko. "Comparison between intraperitoneal onlay mesh repair with closure of fascial defect (IPOM plus) and intraperitoneal onlay mesh repair (IPOM) for ventral hernias." Zaporozhye Medical Journal 26, no. 2 (2024): 123–26. http://dx.doi.org/10.14739/2310-1210.2024.2.297664.

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Aim. To evaluate the intraperitoneal onlay mesh repair with closure of fascial defect (IPOM plus) versus intraperitoneal onlay mesh (IPOM) for ventral hernias (VHs). Materials and methods. A total of 89 patients with VHs with a defect between 3–12 cm who underwent a surgery from 2018 to 2023 years were enrolled in this study. All of them were randomly assigned to two groups. Group 1 included 45 patients after intraperitoneal onlay mesh repair with closure of fascial defect (IPOM plus), Group 2 – 44 patients after intraperitoneal onlay mesh (IPOM). The distribution of patients by age, sex, body mass index (BMI), hernia type (primary VH, incisional hernia), American Society of Anesthesiologists (ASA) score was studied. Results. The differences in sex, mean age, patient distribution based on hernia type, BMI, ASA score and hernia orifice size were not statistically significant between the two groups. Therefore, both groups were comparable. The operative time in minutes was 73.17 ± 7.43 in Group 1 and 70.93 ± 8.84 in Group 2 (not statistically significant). The pain score 12 hours after surgery was 5.24 ± 0.60 in Group 1 comparing to 5.02 ± 0.45 in Group 2 (not statistically significant). The pain score 8 days after surgery was 2.88 ± 0.31 in Group 1 comparing to 2.75 ± 0.43 in Group 2 (not statistically significant). There was no significant difference concerning the incidence of early complications between the two groups. 41 (91.11 %) patients of Group 1 and 40 (90.9 %) patients of Group 2 were examined during a 22-month follow-up period. No complications were noted. Conclusions. Laparoscopic ventral hernia repair provides satisfactory results in terms of safety and efficacy. Thus, IPOM plus repair is safe, feasible and offers possible advantages over the standard IPOM technique as reported in the literature. Poor outcomes described in the literature are probably related to independent variables such as mesh and suture types as well as closure technique.

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Aziz, Mahmoud A., Ahmed Elghrieb, Shady Elzeftawy, Mohamed Shetiwy, and Abdelrahman Albahy. "Subcutaneous onlay laparoscopic approach versus laparoscopic intraperitoneal onlay mesh repair of ventral hernia and correction of rectus diastasis: randomized controlled study." Egyptian Journal of Surgery 42, no. 4 (2023): 877–84. http://dx.doi.org/10.4103/ejs.ejs_172_23.

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Background The association between ventral hernia and rectus abdominis diastasis is a common condition especially in multiparous women. Hernia correction alone without midline reinforcement increases the risk of hernia recurrence. Subcutaneous onlay laparoscopic approach (SCOLA) is a new minimally invasive procedure that allows the surgeons to do simultaneous correction of rectus diastasis and hernia mesh repair with low cost without the need for large transverse abdominal incision. Patients and methods 50 patients with non-complicated ventral hernia associated with rectus diastasis without significant redundancy in the skin of the abdominal wall were allocated randomly in 2 groups. 25 patients underwent SCOLA, and 25 patients underwent intraperitoneal on-lay mesh (IPOM) repair. Both techniques were compared as regard operative time, hospital stay, intra and postoperative complications, and recurrence rate. Results IPOM group experienced shorter operative time than SCOLA (115.27±10.54 vs 77.48±12.72) with no significant difference as regard intraoperative complications between both techniques. Although early postoperative pain was significantly less in SCOLA patients (P=0.021), IPOM group had earlier restoration of normal daily activities (P< 0.001). No significant recurrence rate was considered in both groups apart from one case (4%) after IPOM repair. Conclusion SCOLA could be a good choice in the concurrent repair of ventral hernia and rectus diastasis without significant postoperative complications. In addition, the use of regular proline mesh instead of composite mesh significantly decreases the economic burden.

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Oki, Shinya, Shun Akaeda, Saki Naito, Koichi Hashimoto, and Koichi Kobayashi. "Preventing the mesh puncture after the intraperitoneal onlay mesh repair using transabdominal ultrasonography." JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY 36, no. 1 (2020): 151–56. http://dx.doi.org/10.5180/jsgoe.36.1_151.

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Surya Prakash, Pushkar Chandra, and Vimal Mukesh. "Sublay and overlay mesh repair in paraumbilical hernias– which surgery you will prefer??" Asian Journal of Medical Sciences 13, no. 4 (2022): 173–76. http://dx.doi.org/10.3126/ajms.v13i4.41815.

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Background: Paraumbilical hernia accounts for 33.9% of anterior abdominal wall hernia. Mesh can be applied onlay; on the anterior fascia, inlay; in the hernia defect, sublay; to retro-rectus or preperitoneal space or underlay; in the intraperitoneal position. Aims and Objectives: The objectives of the study are as follows:1) To compare the efficacy between sublay and onlay mesh repair for paraumbilical hernia. 2) To compare the safety between sublay and onlay mesh repair for paraumbilical hernia. Materials and Methods: A prospective study was conducted on 120 patients (60 in each group) patients. The patients were randomly allocated in two groups by lottery method. Patients in Group-A were subjected to sublay mesh repair procedure and patients in Group-B were subjected to onlay mesh repair procedure for paraumbilical hernia repair. Postoperatively, every patient was kept under observations for 3–4 days in ward and observed for complications. Postoperatively, all patients were followed at 10 days, 3 months, and 6thmonth to confirm efficacy and safety of the procedure. Results: The average age of Group-A was 39 years and 32 years in Group-B. In Group-A, 55% patients were female and 45% patients were male; whereas in Group-B, 60% patients were female and 40% patients were male. More over sublay mesh repair was effective in 82% patients on the bases of recurrence while this procedure was safe in 90% cases on the bases of complications whereas onlay mesh repair was effective in 90% patient’s cases on the bases of recurrence while this procedure was safe in 93% cases on the bases of complications. Conclusion: Onlay mesh repair technique is more effective, quick, and safe as compared to sublay mesh repair technique for the treatment of paraumbilical hernia.

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Suwa, Katsuhito, Tomoyoshi Okamoto, and Katsuhiko Yanaga. "Is fascial defect closure with intraperitoneal onlay mesh superior to standard intraperitoneal onlay mesh for laparoscopic repair of large incisional hernia?" Asian Journal of Endoscopic Surgery 11, no. 4 (2018): 378–84. http://dx.doi.org/10.1111/ases.12471.

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Surya Prakash, Asha Gaud, and Dinesh Kumar. "Comparative study of open onlay mesh repair versus laparoscopic intraperitoneal dual mesh repair for ventral hernia." Asian Journal of Medical Sciences 15, no. 5 (2024): 243–47. http://dx.doi.org/10.3126/ajms.v15i5.62755.

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Background: Ventral abdominal wall hernia surgery is a common procedure in the armamentarium of surgeons. The most common forms of these surgical procedures in adults are the repair of incisional hernias and surgery for paraumbilical hernias. Aims and Objectives: Open onlay mesh repair versus laparoscopic intraperitoneal dual mesh repair (intraperitoneal onlay mesh[IPOM]) for ventral hernia compared to the duration of surgery, post-operative pain, postoperative complications, post-operative hospital stay, return to normal activity, recurrence, and cosmesis. Materials and Methods: The prospective non-randomized study was done in the Maharani Laxmi Bai Medical College, Jhansi, between January 2021 and June 2022 including 100 patients was applied for treatment of ventral hernia repair. Fifty patients were subjected to Group A (open onlay mesh repair) and 50 patients were subjected to Group B (laparoscopic intraperitoneal dual mesh repair). Results: The mean surgery durations were significantly lower in laparoscopic repair when compared to open repair (P<0.001). Themean post-operative stay in the hospital was shorter for the laparoscopic group than for the open hernia group (10.28±2.100 vs. 8.02±1.378 days; P≤0.001). Return to activity or normal daily work is significantly lower in the laparoscopic group as compared to open repair of hernia (5.12±0.659 vs. 2.94±0.550 days; P<0.001). There were fewer post-operative complications with laparoscopy. Conclusion: Laparoscopic intraperitoneal dual mesh repair (IPOM) for ventral hernia in our experience was safe and resulted in fewer complications, shorter hospital stays, and better cosmesis results. Hence, it should be considered the better choice for ventral hernia repair.

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Pervin, Mst Shahnaj, Hasan Shahriar Md Nuruzzaman, Eliza Sultana, and Anis Uddin Ahmad. "Comparison of Onlay versus Sublay Mesh Repair in Ventral Hernia : Our Experience in a Peripheral Hospital." Journal of Surgical Sciences 24, no. 2 (2021): 61–65. http://dx.doi.org/10.3329/jss.v24i2.52316.

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Background: Mesh repair is the standard procedure of choice for the ventral hernia repair. The common techniques for this surgery are onlay and sublay repair. But the superior technique between the two is yet to be established objectives. Objectives: We conducted this study to compare the results of Onlay with Sublay mesh repair for the treatment of ventral hernia. Methods: This comparative study was conducted at the department of Surgery, Shaheed Tajuddin Ahmad Medical College Hospital, Gazipur from April 2018 to April 2019. 20 patients withclinically diagnosed ventral hernia were randomized into two groups. The patients in group A had onlay mesh repair while those of group B hadsublay mesh repair. Comparison between the two methods were made in terms of operative time, technical ease, early post operative events specially drain & complication, hospital stay, recurrence. Result: Twenty patients between 20 to 70 years of age among whom 6 are male and 14 are female with different types of ventral hernia including paraumbilical, umbilical, epigastric and incisional, except with defect more than 15 cm were studied. The sublay repair took significantly longer operative time (p = .023). Onlay repair group had more seroma formation, wound infection and recurrence, though not statistically significant. Patients who underwent sublay repair had early removal of drains (3.7 ± .823 days vs 6 ± .738 days) which was significant (p= .000). At the same time sublay repair group had significantly shorter hospital stay than the onlay group (4.5 ± 1.900 days vs 6 ± 1.354 days, p= .023). Conclusion: Sublay repair seems to be a better alternative than onlay repair of Ventral hernia. Randomised controlled trial with larger case numbers is needed to validate the result. Journal of Surgical Sciences (2020) Vol. 24 (2) : 61-65

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Saleem, Saadan, Syeda Rifaat Qamar Naqvi, Aimen Luqman, Hasnain Razzaque, Mahlail Hassan Khan, and Qazi Tafheem Ul Haq. "Outcomes of Onlay Versus Sublay Mesh Hernioplasty for Ventral Abdominal Hernias." Pakistan Armed Forces Medical Journal 74, no. 6 (2024): 1524–27. https://doi.org/10.51253/pafmj.v74i6.8732.

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Objective: To compare surgical outcomes of Onlay versus Sublay technique of mesh hernioplasty among patients with ventral abdominal hernia. Study Design: Quasi-experimental study. Place and Duration of Study: Department of General Surgery, Combined Military Hospital, Rawalpindi Pakistan, from Oct 2021 to Mar 2022. Methodology: A total of 78 patients were selected, using convenience sampling, with reducible incisional, paraumbilical, supraumbilical or epigastric hernia, with a hernial defect measuring ≥2 cm. All preoperative parameters were recorded, and postoperative outcomes were monitored on follow-up at 2 weeks, 1 month and 2 months. Data was analyzed for statistical significance with p-value ≤0.05 being considered significant. Results: Open Onlay repair was performed on 41(52.6%) patients whereas the remaining 37(47.4%) cases had open Sublay mesh hernioplasty. The commonest ventral hernia types were paraumbilical 43(55.1%) and incisional 28(35.9%). Sublay procedure lasted for a significantly longer duration (p<0.001) but wound infections (OR: 1.67) and seromas (OR: 1.50) were slightly more frequent among the Onlay repair group (p=0.372 and p=0.521 respectively) whereas postoperative pain and wound dehiscence showed a similar rate of occurrence. Recurrence was more common after Sublay repair (14, 38%) as compared to Onlay 10(24.4%). Conclusion: The comparison between Onlay and Sublay mesh hernioplasty showed comparable surgical outcomes, with each technique presenting distinct advantages. While Sublay procedures took longer and had higher recurrence rates, they showed slightly lower wound complications. The choice of technique should be individualized based on patient factors and surgeon expertise.

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Denney, Brad, and Jorge I. De Latorre. "Multipoint Suture Fixation Technique for Abdominal Wall Reconstruction with Component Separation and Onlay Biological Mesh Placement." American Surgeon 83, no. 5 (2017): 515–21. http://dx.doi.org/10.1177/000313481708300529.

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Component separation with mesh reinforcement has become the primary modality for complex abdominal wall reconstruction. However, many fundamental questions remain unanswered, such as whether underlay versus overlay mesh placement is superior, and what is the best means of suture fixation technique for mesh placement? This study presents the senior author's technique for onlay biologic mesh placement with multipoint suture fixation in combination with component separation and its subsequent low recurrence rates. This is a retrospective review of the senior author's cases of component separation with onlay biologic mesh placement during his tenure at the home institution of the University of Alabama at Birmingham. A total of 75 patients were included, all of whom underwent complex abdominal wall reconstruction from September 2002 to April 2012. Patients were excluded from the dataset if their surgery occurred less than two years before date of data collection to give a minimum 2-year follow-up. Patients were identified by Current Procedural Terminology codes for component separation and their charts reviewed by the home institution's electronic medical record. Data point entries included patient demographics and comorbidities, concomitant procedures such as bowel resection or panniculectomy, and characteristics of the reconstruction such as type of mesh used. Primary data endpoints were complications following surgery, particularly recurrence and laxity. A total of 75 patients were included in the study from September 2002 to April 2012 with a minimum 2-year follow-up period. The recurrence rate was 13 per cent and the rate of laxity 2.7 per cent. There was one death (1.35%). The most frequent complication was seromas at a rate of 17 per cent. Multipoint fixation suture technique for abdominal wall reconstruction with component separation and onlay biologic mesh is a reproducible technique with reliably low recurrence rates.

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Wangkulangkul, Piyanun, Thirada Naphattalung та Siripong Chewatanagongun. "ทางเลือกปัจจุบันและแนวโน้มในอนาคตของการผ่าตัดไส้เลื่อนสะดือในผู้ใหญ่". PSU Medical Journal 2, № 1 (2022): 33–42. http://dx.doi.org/10.31584/psumj.2022249191.

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ไส้เลื่อนสะดือในผู้ใหญ่พบได้บ่อยมักเป็นขึ้นมาภายหลัง การเลือกวิธีการผ่าตัดให้เหมาะกับผู้ป่วยมีความสำคัญส่งผลต่อผลการรักษาและภาวะแทรกซ้อนได้ ปัจจุบันผลการรักษาด้วยการเย็บปิดเพียงอย่างเดียวเกิดการกลับเป็นซ้ำได้ง่ายและแนะนำให้ใช้เฉพาะไส้เลื่อนสะดือขนาดเล็กเท่านั้น และมีแนวโน้มแนะนำให้ใช้ mesh มากขึ้นโดยเฉพาะการผ่าตัดไส้เลื่อนแบบเปิดขนาดกลางขึ้นไป ผู้ป่วยกลุ่มความเสี่ยงสูงต่อภาวะแทรกซ้อนของแผล หรือเสี่ยงต่อการกลับเป็นซ้ำ กลุ่มนี้แนะนำให้ผ่าตัดด้วยวิธี minimally invasive โดยเปลี่ยนความนิยมจาก Intraperitoneal onlay mesh ไปเป็น retrorectus mesh repair ด้วยวิธีต่างๆทั้งการผ่าตัดผ่านกล้องและผ่าตัดด้วยหุ่นยนต์

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Ravindrakumar, Chandru, Saravanan Sanniyasi, Pervez Ahmed, and Surya Subramaniam. "Laparoendoscopic Approach in the Management of Abdominal Wall Hernia - Our Initial Experience from Chennai, India." Journal of Evolution of Medical and Dental Sciences 10, no. 31 (2021): 2422–26. http://dx.doi.org/10.14260/jemds/2021/496.

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BACKGROUND Incisional hernias are a common occurrence following midline laparotomy. Numerous techniques have been employed in the management of this common condition. Randomized trials and evidence based medicine help us in deciding what the optimal treatment is in a particular condition. This is often not possible in case of hernia due to the heterogeneity of population. Laparoscopy is gaining popularity in the management of this condition as results are comparable to open surgery with lesser post-operative pain. The placement of mesh intraperitoneally as in laparoscopic intraperitoneal onlay mesh repair has its own disadvantage such as mesh erosion into viscera. Placement of mesh endoscopically as an onlay repair seems to be a good option, more so in the developing world, considering the prohibitive cost of composite mesh. The purpose of this study was to analyze the technical ease, reproducibility, outcome, postoperative pain and complications of laparoendoscopic hybrid technique in the management of abdominal wall hernia. METHODS This technique combines the benefits of minimal invasive surgery and ease of onlay mesh repair, while reducing wound related problems associated with open surgery. It involves first a laparoscopic approach in entry, reducing the contents, visualizing the sac followed by endoscopic dissection using the same trocar anterior to abdominal wall in the subcutaneous plane. This is followed by sac dissection, suturing the abdominal wall and placing an onlay mesh RESULTS Fifteen patients have been operated; no subcutaneous drains were placed. A polypropylene onlay mesh was used and fixation done with suturing. No major complications were seen. There was no subcutaneous emphysema. CONCLUSIONS The laparoendoscopic hybrid technique offers advantage of being minimally invasive and having lower wound related complications, with early ambulation and decreased hospital stay. It is also technically easier to suture the defect and allow complete excision of the sac. However a randomized trial is necessary and larger series are required to compare the results with other established techniques. KEY WORDS Incisional Hernia, Laparo - Endoscopic - Onlay Mesh, Surgical Techniques, SCOLA

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Fahim Liaqat, Muhammad Qasim Butt, Usman Ghani, Mansoor Tariq Azeem, Muhammad Shoaib Khan, and Tayyaba Mushtaq Khan. "Comparison of Onlay Mesh Repair Vs Sublay Mesh Repair for Ventral Abdominal Hernias: A Focus on Post Op Seroma Formation." Pakistan Armed Forces Medical Journal 74, SUPPL-2 (2024): S199—S203. http://dx.doi.org/10.51253/pafmj.v74isuppl-2.5989.

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Objective: To compare the effectiveness of Onlay mesh repair versus Sublay mesh repair for ventral abdominal hernias in terms of post op seroma formation. Study Design: Quasi-experimental study. Place and Duration of Study: Department of General Surgery, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Feb to Sep 2020. Methodolgy: A total of 140 patients (70 in each group) of ventral abdominal hernia who met the inclusion and exclusion criteria were included in the study. Patients with complicated or recurrent hernias were excluded. Group-A patients underwent Onlay hernioplasty while in group B hernioplasty was performed via Sublay technique. All patients were followed for post op seroma formation till 2 weeks via ultrasonography. Data was analyzed by Statistical Package for Social Sciences version 22. Results: Mean operation time in Group-A was 52.30±6.65 minutes while in Group-B the mean operation time was 85.82±8.26 minutes. Post op seroma formation between the two groups was 18.10% vs 4.65%, which was statistically significant (p=0.023). Conclusion: The occurrence of Post op seroma formation is less in Sublay lay mesh repair as compare to Onlay mesh repair however it requires longer operative time.

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Subramanya, M. S., J. Chakraborty, B. Memon, and M. A. Memon. "Emergency Intraperitoneal Onlay Mesh Repair of Incarcerated Spigelian Hernia." JSLS : Journal of the Society of Laparoendoscopic Surgeons 14, no. 2 (2010): 275–78. http://dx.doi.org/10.4293/108680810x12785289144683.

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Pakula, Andrea M., and Ruby A. Skinner. "From intraperitoneal onlay mesh repair to transversus abdominus release." Journal of Trauma and Acute Care Surgery 87, no. 1 (2019): 251–53. http://dx.doi.org/10.1097/ta.0000000000002252.

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