Approach to Ventral Abdominal Hernias: Anatomical Repair Versus Open Mesh Repair

Introduction: Ventral abdominal hernias are a prevalent surgical issue that can greatly affect a patient's quality of life. Although several surgical methods have been devised to treat these hernias, there remains ongoing discussion about the best approach. The goal of this study is to compare the results of anatomical repair and open mesh repair in patients with ventral abdominal hernias.  Methods: This prospective study examined anatomical repair and open mesh repair for ventral abdominal hernias in 60 patients over 18 months at Navodaya Medical College Hospital and Research Centre in Raichur. Patients with uncomplicated ventral hernias and defects smaller than 3 cm were randomly assigned to two groups of 30 each. The study assessed various outcomes, including operative time, post-operative pain, hospital stay, complications, and recurrence rates.  Results: This study showed that mesh repair had significantly shorter operation times (p<0.001) compared to anatomical repair. While not statistically significant, the mesh repair group demonstrated trends towards lower rates of seroma formation (3.3% vs 16.7%), wound infection (3.3% vs 16.7%), and early recurrence (0% vs 16.7%, p=0.052). Post-operative pain scores and return to normal activity rates were similar between groups. Patient satisfaction was higher in the mesh repair group.  Conclusion: The study concludes that meshplasty is superior to anatomical repair for ventral abdominal hernias, offering improved outcomes with minimal associated morbidity. These findings support the use of mesh repair as the preferred surgical technique for ventral abdominal hernias.