Abstract

 BACKGROUND:
Incisional hernia after abdominal surgery is a well-known complication and the incidence of incisional
hernias continues to be 2-11% after laparotomy. The repair of incisional hernia has always been a
challenge to the surgeon. Various operative techniques for the repair of incisional hernia are in practice;
however, the management is not standardized. The sublay technique, popularized by Rives and Stoppa
in Europe, has been reported to be quite effective, with low recurrence rates and minimal
complications.
OBJECTIVE:
To study the advantage and complications of sublay mesh repair of incisional hernias in comparison to
onlay mesh repair.
METHODS:
Record of 110 patients undergoing repair of incisional hernia from 1st Jun 2013 to 1st Jun 2015,
excluding very large incisional hernia with defect more than 10 cm. 62 cases of incisional hernias were
managed by onlay mesh repair and 48 cases of incisional hernia 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 2 patients (4.3%) . wound infection was 2 patients (4.3%). No
septic mesh was removed in the series. In onlay group seroma formation was in 12 patients (19.4%)
most of seroma occur in large incisional hernias repair, wound infection was in 5 patients (8.1%) and 2
septic mesh was removed. In sublay, recurrence rate was one patient (2.1%), in onlay, recurrence rate
was in 5 patients (8%).
CONCLUSION:
Sublay mesh although it is more time consuming and technically more difficult, however it carries low
recurrence rate and few post-operative wound complication .