Background: Ventral hernia is a protrusion of
an abdominal viscus or part of a viscus through
the anterior abdominal wall. Ventral hernias are
common clinical entity encountered in people of all
age groups. They present a challenge because they
occur in variety of sizes, may be quite complicated
to repair and have relatively high recurrence rates.
Mesh repair in ventral hernia can be onlay , inlay, pre
peritoneal. Each of the mesh placement techniques
are practiced widely and each have their own
advantages and disadvantages. This is a prospective
study to compare the pre peritoneal mesh repair and
onlay mesh repair techniques and their outcomes in
management of ventral hernias.

Aims and Objectives: To compare the onlay and pre
peritoneal mesh repair techniques and their outcomes
with respect to post operative pain , seroma formation,
wound infection and recurrence in the management
of ventral hernias. To assess the anatomical, clinic
pathological factors leading to ventral hernias.

Methods: Source of data:
Patients diagnosed by the surgeon as confirmed
cases of ventral hernias, admitted department of
general surgery, in hospitals attached to Bangalore
Medical College and Research Institute, Bengaluru

Methodology:It was a Prospective comparative study
Total sample size was 100.
After admission, patients fulfilling the inclusion
& exclusion criteria were taken into study after
obtaining written informed consent.
Patients were allotted to groups randomly using
computer generated random number.
Group A were 50 cases who underwent onlay mesh
repair and group B were 50 cases who underwent pre
peritoneal mesh repair
Patient details and investigations were recorded
were recorded in the case record form (CRF) at
baseline visit .
Patients underwent the mesh repair and duration
of surgery was recorded.
Patients were followed up at 4 weeks (visit 2), 8
weeks (visit 3) and 24weeks (visit 4) after the surgery.
The various complications were studied in the follw
up visits.

Results:The mean operative time was 46.68 minutes in
onlay group and 56.26 minutes in pre-peritoneal
group showing statistical significance. In our study,
22% of onlay group and 6.0% of pre-peritoneal group
complaint of chronic post operative pain during the
follow up visits showing p value which is statistically
significant. 22% were in onlay group and 6.0% in
pre-peritoneal group developed seroma with a p
value showing statistical significance. Average post
operative hospital stay period in present series for
onlay repair was 7.48 days, as compared to 5.90 days
average stay for Pre-peritoneal Mesh repair which
also was statistically significant.

Conclusion: According to our study onlay repair
had more complication rates in terms of seroma and
post operative pain compared to pre-peritoneal mesh
repair. Even though the operative time for onlay
NIJS / Volume 11 Number 3 / July–September 2020
332 New Indian Journal of Surgery
repair was less, increased chances of complications
limit its use. Taking into consideration all the above
our study concludes that pre peritoneal mesh repair
is superior to onlay mesh repair.

Keywords: Ventral hernia; Mesh repair; Onlay;
Pre-peritoneal; Seroma; Post operative pain.