Publication:

A comparative study of on-lay and preperitoneal mesh repair in the management of umbilical hernia

Background Umbilical hernias can cause distress to the patients not only because of their complications but also because of the cosmetic angle, therefore this study was undertaken mainly to study the outcomes of preperitoneal mesh repair and on-lay mesh repair in the management of umbilical hernias.

Methods The present study was a prospective, observational and comparative study undertaken in the department of general surgery, who had been operated in Kamineni hospital LB Nagar, Hyderabad, Telangana, during a study period from November-2020 to September-2021.

Results Of 30 patients who underwent on-lay mesh repair, the mean hospital stay was 3.83±1.8 days; wound infection, seroma, hematoma, flap necrosis was seen in 1, 4, 2, 1 respectively and with no recurrence in 6 months follow-up. Of 30 patients who underwent pre-peritoneal mesh repair, the mean hospital stay was 2.13±0.63 days; Wound infection, seroma, hematoma, flap necrosis was seen in 0, 2, 1, 0 respectively and with no recurrence in 6 months follow-up.

Conclusions On-lay mesh repair can be replaced with preperitoneal mesh repair. Overall mesh related complications, including wound infection, seroma, hematoma, flap necrosis is quite rare. Less Hospital stay and low recurrence rate was observed in preperitoneal method. As wound complication increases risk of recurrence, procedures that do not result in formation of de-vascularizing flaps may be recommended.