Outcome of Open Intraperitoneal Dual Mesh Versus on–Lay Mesh for Incisional Hernia Repair

Abstract

Background : incisional hernia is any abdominal wall gap with or without a bulge in the area of a postoperative scar. There are different methods for treating incisional hernia . Mesh is always used to decrease the recurrence rate to less than 10%. Different types and different methods of mesh hernioplasty.
Objective : to compare the outcome of open intraperitoneal mesh versus on-lay mesh hernioplasty.
Method : this prospective study conducted in Al- Fayhaa Teaching hospital between February 2016 and February 2018. The patients with incisional hernia are divided into two groups . Group A treated by open intraperitoneal optimized composite mesh, and group B managed by on-lay mesh .the patients followed for 24 months following surgery to compare between the two groups regarding , operative time , hospital stay and post operative complications.
Result : eighty patients included in the study . In group A , the mean operative time was ( 90 ±10.24 minutes) while for group B was ( 70 ± 17.53 minutes ). The average hospital stay was ( 3.34 ± 1.27 days) and ( 5 ± 3.73 days) for group A and group B respectively .seroma developed in 12.5% for intraperitoneal group and 27% for on-lay group. Surgical site infection was 2.5% in group A and 15 % in group B. No patient developed recurrence of hernia in group A , while 7.5 % of group B developed recurrence during the period of follow up.
Conclusion: open intraperitoneal mesh hernioplasty is much better than on-lay method regarding the operative time , hospital stay and post operative complications.