A comparative study of 50 cases (25 each) of On-lay versus pre-peritoneal hernioplasty in incisional hernia

Background:An incisional hernia is a bulge or protrusion that occurs near or directly along a prior abdominal surgical incision. The objective of this study was to make comparison between On-lay and Pre-peritoneal method of hernioplasty in incisional hernia in term of operative time, post-operative morbidity, complications, hospital stay, return to routine work, and recurrence rate.Methods: The present study, prospective and observational, was carried out in surgery department of B.J. Medical College, Ahmedabad, Gujarat, India from October 2010 to August 2012. 50 cases of incisional hernia were randomly placed in On-lay and Pre-peritoneal group. Observations were made with regards to duration and ease of operation, wound complications, hospital stay, morbidity and recurrence. Patient’s information was recorded in the performa containing demographic details, method of repair, intra operative, early post-operative and late post-operative complications.Results:Out of 50 patients enrolled, mean age in On-lay group is 49.16 years. While in pre-peritoneal group mean age is 40.68 years and female to male ratio of incisional hernia is 2.57:1. In pre-peritoneal meshplasty postoperatively seroma formation is (24%), post-operative stay is 9.24 day, wound infection (8%), while in On-lay meshplasty seroma formation is (52%), and stay is 12.28 day, wound infection (36%). Recurrence and mesh removal rate is more in our series in On-lay repair.Conclusions:In view of less post-operative complications like seroma, wound infection, mesh removal and early returns to routine work & less recurrence ;pre-peritoneal meshplasty is better repair for incisional hernia compared to on-lay meshplasty; in our study.