Ventral Abdominal Wall Hernioplasty: Insights into Intraperitoneal Onlay Mesh Vs Sublay Technique, A Retrospective Cross-Sectional Study

Background: Ventral abdominal wall hernia represents a common surgical problem that is linked to morbidity, prolonged recovery duration, and high costs of healthcare. The purpose of this study was to compare the outcome of perioperative, postoperative pain, and complication rate in open sublay versus laparoscopic IPOM repair in a tertiary care hospital. Methods: This retrospective cross-sectional study (March to November 2025) comprised of 120 patients underwent ventral hernia repair, were divided into two groups (Group A (open sublay, n=60), and Group B (laparoscopic/IPOM, n=60)). Demographic data, comorbid data, operative data, mesh size, use of analgesics and antibiotics, drain data, hospitalization, Visual Analogue Scale (VAS) pain scores and postoperative complications were recorded. Independent t-tests and the Fisher exact test were used as statistical tests, with the p-value of less than 0.05 being regarded as significant. Results: Laparoscopic/IPOM group demonstrated better results in the time spent in operations (46.35 ± 5.7 vs. 59.53 ± 8.4 min, p=0.001) and days in the hospital (3.0 ± 1.0 vs. 5.0 ± 2.0 days, p<0.001). The levels of postoperative pain were also reduced and 86% of the patients had mild pain (VAS <3), as compared to 33% in the open group (p=0.0001). There were also less analgesics and drain requirements in the laparoscopic group. Conclusion: Laparoscopic/IPOM repair is the most effective in terms of faster recovery, less postoperative pain, less perioperative burden, and safety equivalent than that of open sublay repair. These results promote laparoscopy repair as a convenient method in the management of ventral hernias.