DOI: 10.1093/qjmed/hcad069.325 ISSN:

A Comparative Study between Onlay versus Sublay Mesh Repair in Treatment of Midline Incisional Hernia

Sherif A Ahmed, Ibrahem M Abd_Elaksoud, Mohamed N Saad
  • General Medicine



Incisional hernia is a common complication following laparotomy and is the most common indication for reoperation. However, the optimal approach for its repair is still a matter of debate.

Aim of Study

The aim of this study was to compare between onlay and sublay mesh repairs in treatment of midline incisional hernia regarding the operative technique and postoperative complications.

Patients and Methods

This randomized controlled prospective comparative study was conducted in general surgery department Ain-Shams University Hospital and Damanhour Medical National Institute in the period between November 2019 and April 2020. It included 40 patients with Midline incisional hernia who were randomly divided into two equal groups: A (treated with sublay repair) and B (treated with onblay repair).


The mean operative time in group A was 104.2 minutes and in group B was 82.9 minutes. The mean time of drain removal in group A was 4.3 days while in group B was 13.6x days. Seroma formation after drain removal was not recorded in any patients of group A while it occurred in 4 patients in group B (20%). The other postoperative complications were comparable in both groups. During 6 months of follow up, hernia recurrence didn’t occurs in any patient in group A nor group B.


Sublay mesh repair of incisional hernia is a good alternative to onlay repair. It is applicable to all sites of incisional hernia with a low recurrence rate and acceptable complication rates.

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