Related Experiment Video
Updated: Aug 12, 2025
05:15
Application of a New Mesh Fixation Method in Laparoscopic Incisional Hernia Repair
Published on: December 23, 2022
6.5K
Onlay Versus Sublay Mesh Repair for Incisional Hernias: A Systematic Review.
Chirag Pereira1, Shankar Gururaj2
1General Surgery, Royal Lancaster Infirmary, Lancaster, GBR.
Cureus
|January 30, 2023
Summary
Onlay and sublay mesh repairs for incisional hernias show similar recurrence rates. However, onlay repair is linked to significantly more seroma formation, with no significant differences in infection or hospital stay.
Area of Science:
- General Surgery
- Abdominal Surgery
- Hernia Repair
Background:
- Incisional hernias are a frequent complication after major abdominal surgery.
- Various surgical techniques exist for mesh placement in incisional hernia repair.
- Comparing onlay and sublay mesh repair strategies is crucial for optimizing patient outcomes.
Purpose of the Study:
- To systematically compare the efficacy and safety of onlay versus sublay mesh repair for incisional hernias.
- To analyze key outcomes including hernia recurrence, seroma formation, surgical site infection, and hospital stay.
Main Methods:
- A systematic literature search was performed across Embase, Cochrane Library, PubMed, and Medline.
- Included randomized controlled trials (RCTs) comparing onlay and sublay mesh repair for incisional hernias.
- Meta-analysis of data from six RCTs involving 986 patients.
Main Results:
- No statistically significant difference in hernia recurrence rates between onlay and sublay groups (OR: 1.3; p=0.60).
- Seroma formation was significantly higher in the onlay group compared to the sublay group (OR: 2.85; p<0.0001).
- No significant differences were observed in surgical site infection (SSI) rates, haematoma formation, or length of hospital stay between the two techniques.
Conclusions:
- Current evidence suggests comparable hernia recurrence rates for onlay and sublay mesh repair.
- Onlay repair is associated with a higher incidence of seroma formation.
- Further large-scale, well-structured RCTs are needed to provide definitive clinical recommendations for incisional hernia management.
