A study on comparison of retro-muscular pre-fascial placement of mesh versus other methods of mesh repair of ventral hernias

  • Dr Jitendra Darshan Professor, Department of Surgery, Surat Municipal Institute of Medical Education and Research, Nr Bombay Market, Surat, Gujrat, India
  • Dr Archana Nema Professor, Department of Surgery, Surat Municipal Institute of Medical Education and Research, Nr Bombay Market, Surat, Gujrat, India
  • Dr Jenish Sheth Assistant Professor, Department of Surgery, Surat Municipal Institute of Medical Education and Research, Nr Bombay Market, Surat, Gujrat, India
  • Dr Jaypalsinh Ashoksinh Gohil Resident, Department of Surgery, Surat Municipal Institute of Medical Education and Research, Nr Bombay Market, Surat, Gujrat, India
Keywords: Ventral hernias, Meshplasty, Retro-muscular, Inlay, Onlay & underlay meshplasty

Abstract

Introduction: Ventral hernias repair are most routinely performed procedure in daily life of general surgeons. The objective of the present study is to compare the outcome of retro-muscular repair over other methods of ventral hernia repair.

Methodology: 90 diagnosed cases of ventral hernias were randomly split into two groups A (retro-muscular meshplasty) and B (onlay, inlay & underlay meshplasty). The comparison across groups was carried out in terms of operation length, postoperative pain, wound complications, length of hospital stay & recurrence.

Results: No difference was found between the groups regarding age, gender, type and classification of hernia. Operation length was 110 min in retro-muscular repair and 90min in onlay and 114 min underlay method. Statistically difference was seen between these groups. Among complications recurrence, seroma, mesh infection and wound complications were seen in group B. Postoperative pain and well being score were better in retro-muscular group.

Conclusions: Retro-muscular meshplasty have more advantage compare to other open methods in ventral hernia repair. Retro-muscular meshplasty is still most appropriate method in open ventral hernia repair

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References

1. Bucknall TE, Cox PJ, Ellis H. Burst abdomen and incisional hernia: a prospective study of 1129 major laparotomies. Br Med J (Clin Res Ed). 1982 Mar 27;284(6320):931-3.[pubmed]

2. George CD, Ellis H. The results of incisional hernia repair: a twelve year review. Ann R Coll Surg Engl. 1986 Jul;68(4):185-7.[pubmed]

3. Luijendijk RW1, Hop WC, van den Tol MP, et al. A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med. 2000 Aug 10;343(6):392-8. DOI:10.1056/NEJM200008103430603.[pubmed]

4. Burger JW, Luijendijk RW, Hop WC, et al. Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg. 2004 Oct;240(4):578-83; discussion 583-5.[pubmed]

5. Mudge M, Hughes LE. Incisional hernia: a 10 year prospective study of incidence and attitudes. Br J Surg. 1985 Jan;72(1):70-1.[pubmed]

6. Anthony T, Bergen PC, Kim LT, et al. Factors affecting recurrence following incisional herniorrhaphy. World J Surg. 2000 Jan;24(1):95-100;discussion 101.[pubmed]

7. Bucknall TE, Cox PJ, Ellis H. Burst abdomen and incisional hernia: a prospective study of 1129 major laparotomies. Br Med J (Clin Res Ed). 1982 Mar 27;284(6320):931-3.[pubmed]

8. OBNEY N. An analysis of 192 consecutive cases of incisional hernia. Can Med Assoc J. 1957 Sep 1;77(5):463-9.[pubmed]

9. Condon RE. Ventral Abdominal Hernia 2001. In Baker RJ, Fischer JE editors Mastery of Surgery 4th edition. Philadelphia: Lippincott Williams & Wilkins.

10. Toms AP, Dixon AK, Murphy JM, et al. Illustrated review of new imaging techniques in the diagnosis of abdominal wall hernias. Br J Surg. 1999 Oct;86(10):1243-9.[pubmed]

11. Bauer JJ, Salky BA, Gelernt IM, et al. Repair of large abdominal wall defects with expanded polytetrafluoroethylene (PTFE). Ann Surg. 1987 Dec;206(6):765-9.[pubmed]

12. FS Aoda et al. Underlay versus onlay mesh repair of ventral hernias. QMJ VOL.9 No.16, p-208-216.

13. Poelman MM, Langenhorst BL, Schellekens JF, et al. Modified onlay technique for the repair of the more complicated incisional hernias: single-centre evaluation of a large cohort. Hernia. 2010 Aug;14(4):369-74. doi: 10.1007/s10029-010-0646-3. Epub 2010 Mar 14.[pubmed]

14. Cassar K, Munro A. Surgical treatment of incisional hernia. Br J Surg. 2002 May;89(5):534-45.[pubmed]

15. Luijendijk RW, de Lange DC, Wauters CC, et al. Foreign material in postoperative adhesions. Ann Surg. 1996 Mar;223(3):242-8.[pubmed]

16. Korenkov M, Beckers A, Koebke J, et al. Biomechanical and morphological types of the linea alba and its possible role in the pathogenesis of midline incisional hernia. Eur J Surg. 2001 Dec;167(12):909-14. DOI10.1080/110241501753361596.[pubmed]

17. Peter Tyrer. Classification of pain & Description of pain. Cambridge textbook of effective treatments in psychiatry. Vol 3, p151-185.

18. Peter Tyrer. Classification of well being score & Description. Cambridge textbook of effective treatments in psychiatry. Vol 3, p351-385.

19. Welty G1, Klinge U, Klosterhalfen B, et al. Functional impairment and complaints following incisional hernia repair with different polypropylene meshes. Hernia. 2001 Sep;5(3):142-7.[pubmed]
CITATION
DOI: 10.17511/ijoso.2018.i04.08
Published: 2019-10-23
How to Cite
Darshan, J., Nema, A., Sheth, J., & Ashoksinh Gohil, J. (2019). A study on comparison of retro-muscular pre-fascial placement of mesh versus other methods of mesh repair of ventral hernias. Surgical Review: International Journal of Surgery, Trauma and Orthopedics, 4(4), 177- 182. https://doi.org/10.17511/ijoso.2018.i04.08
Section
Original Article