A Randomised Prospective Study to Evaluate Preperitoneal Mesh Repair Versus Onlay Mesh Repair and Laparoscopic IPOM in Incisional Hernia Surgery

Incisional hernia remains a very common postoperative complication. These are encountered with an incidence of up to 20 % following laparotomy. These hernias enlarge over time, making the repair difficult, and serious complications like bowel obstruction, strangulation and enterocutaneous fistula can occur. Hence, elective repair is indicated to avoid these complications. Implantation of a prosthetic mesh is nowadays considered as the standard treatment due to low hernia recurrence. The most common mesh repair techniques used are the onlay repair, sublay repair and laparoscopic intraperitoneal onlay mesh (IPOM). However, it is still not clear which technique among the three is superior. A study consisting of 30 patients who underwent incisional hernia repair by onlay, laparoscopic and preperitoneal mesh repair with abdominoplasty was conducted in the Coimbatore Medical College and Hospital. Of the three groups, the preperitoneal repair with abdominoplasty was found to have better patient compliance and satisfaction with regard to occurrence of complications and appearance of the abdominal wall without laxity in a single sitting.