COMPARISON BETWEEN ON LAY AND SUBLAY METHODS OF MESH REPAIR OF INCISIONAL HERNIA

Objective: To evaluate the repair of incisional hernia by two different methods onlay (Conventional method) and sublay(retromuscular preperitoneal) methods at two different tertiary care centres of Karachi - Pakistan. Methodology: Patients diagnosed clinically and confirmed ultrasonographically and subsequently operated upon with either methods were included in this study. The primary endpoint was hernia recurrence. Secondary endpoints were operative time, length of hospital stay and postoperative complications of the two methods. Results: A total of 80 patients were allocated in two groups, group A (n=40) underwent incisional hernia repair by sublay method and the remaining in Group B, (n=40) by onlay method. The frequency of wound infection was found significantly higher in the Sublay method of mesh placement (p=0.019). The frequency of seroma formation was significantly higher in the onlay method of mesh placement(p=0.076) Conclusions: The sublay technique was proven to be very effective, with minimal complications and low recurrence rate.