Comparative evaluation of onlay vs sublay mesh in treatment of ventral hernias.

Abstract

Hernias of the anterior abdominal wall, or ventral hernias have a various type that can be categorized into primary ventral hernias which include two subtypes lateral ventral hernia, and midline ventral hernias, and incisional hernias (acquired hernias) is another type according to the location, occur at the site of a pervious surgical scar. The cause of a primary ventral hernia is far from completely understood, but it is undoubtedly multifactorial. Familial predisposition plays an important role. There is increasing evidence that connective tissue disorders considered as a leading cause of ventral hernias. An estimated one-quarter of all individuals are either born with or will develop a ventral hernia in their lifetimes. The evaluation of ventral hernia requires diligent physical examination combined with imaging modalities that play a greater role in diagnosis of more unusual or complicated hernias. Complications of ventral hernia include effects of strangulation and postoperative complications, but recurrence still the ultimate nightmare of hernia surgeon. Recurrence reduced after use of permanent prosthetic mesh for repair. Classically repair was done proposed by Mayo, but with increased tension on the repair and recurrence rates almost 30%, instead defects are closed primarily and reinforced via prosthetic mesh, fascial auto grafts or metallic mesh.