A comparison study between retro-rectus and onlay mesh repair outcomes for ventral hernia in a tertiary care center

Abstract

BACKGROUND: Ventral hernias refer to a weakening or defect in the abdominal wall through which abdominal contents can protrude. Ventral hernia is a frequent problem in surgical practice which includes primary and incisional. Mesh repair is still the gold standard. Open approaches include retro-rectus (Rives-Stoppa) and onlay repair.

OBJECTIVES: The purpose of this study is to evaluate and compare the outcomes of both repairs in terms of efficacy and techniques, time taken for surgery, postoperative pain, length of hospital stays, complications, and recurrence.

MATERIALS AND METHODS: A retrospective study of 40 patients was carried out in all ventral hernia patients based on clinical and demographic parameters with a Tanaka index less than 25% and defect size less than 10 cm.

RESULTS: The results overall were more promising toward retro-rectus repair in terms of surgical site infections, skin necrosis, seroma, hematoma, and duration of drain placement (mean duration 2.85 ±0.75 days in retro-rectus group and 5.1 ±2.47 days in onlay group). However, onlay repair was associated with less time taken for surgery (mean duration 97.25 ±10.69 min for retro-rectus and 70.25 ±8.66 min for onlay), less postoperative pain, and shortened hospital stay (4.85 ±1.31 days for retro-rectus group and 3.10 ±1.02 days for onlay). There was no recurrence in both groups in our study.

CONCLUSION: Both approaches have their own pros and cons. The rate of complications and recurrence is lower with retro-rectus repair; however, onlay repair has less intricacies associated with surgery, a lesser learning curve, and an overall straightforward procedure compared to the one mentioned before.

Keywords

Mesh / onlay / retro-rectus / ventral hernia

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International Journal of Abdominal Wall and Hernia Surgery | Published by Wolters Kluwer - Medknow on behalf of Higher Education Press