Component Separation with Sublay (Retro Muscular) Polypropylene Mesh Implantation: Evaluation of Surgical Outcome of 30 Patients in a Tertiary Care Hospital

Background: Incisional hernia after laparotomy is a well-known complication and the repair has always been a challenge to the surgeons. Various operative techniques for the repair of incisional hernia are in practice among which the retro muscular mesh placement or the sublay technique popularized by Rives and Stoppa, has been reported to be quite effective, with low recurrence rates (0-23%) and minimal complications. The aim of this study was to report our experience about retro muscular repair with polypropylene mesh implantation for the treatment of midline incisional hernias. Objective: This study aimed to analyse the pros and cons of the sublay (retro muscular) mesh repair for midline incisional hernias and to evaluate the significance of this technique as a treatment modality. Methods: The study was conducted at the department of surgery BIRDEM general hospital over a period of four years (from December 2019 - November 2023). It was a prospective observational study using 30 cases. Early postoperative complications, post-operative pain (NPRS), drain removal time, postoperative hospital stay and the recurrence rate were the main areas of investigation. All the patients were followed up postoperatively up to 6 weeks for early complications and up to 2 years for recurrence. Results: In most of the cases the duration of operation was ≤120 minutes. Regarding postoperative findings, only 02 patients (6.66%) experienced severe pain after 96 hours where as 56.66% (17 patients) complained mild pain as per NPRS. Subcutaneous seroma was found only 6.66% cases. In most cases drain removal time was ≤4 days (76.66%) and postoperative hospital stay was also ≤4 days in 70% patients. None of our patients developed wound infection, mesh reaction or paralytic ileus as an early postoperative complication and none had developed recurrence up to 24 months follow up. The mean age, sex, BMI of the sample population, clinical presentations and per operative findings were comparable ..