CORRESPONDENCE Year : 2022  |  Volume : 55  |  Issue : 4  |  Page : 162

Author's reply: Comparative analysis of onlay and sublay (retrorectus) mesh repair for incisional hernia (width ≤10 cm) of abdominal wall: A single-center experience

Manoj Kumar, Manoj Kumar, Ashesh Kumar Jha, Abhishek Arora, PP Sreepriya, BS Niroop, Md Ashraf Ali
Department of General Surgery, All India Institute of Medical Sciences, Patna, Bihar, India

Date of Submission12-Jun-2022Date of Acceptance13-Jun-2022Date of Web Publication1-Aug-2022

Correspondence Address:
Manoj Kumar
Room 305, OPD Building, Department of General Surgery, AIIMS, Patna - 801 507, Bihar
India

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/fjs.fjs_61_22

How to cite this article:
Kumar M, Kumar M, Jha AK, Arora A, Sreepriya P P, Niroop B S, Ali MA. Author's reply: Comparative analysis of onlay and sublay (retrorectus) mesh repair for incisional hernia (width ≤10 cm) of abdominal wall: A single-center experience. Formos J Surg 2022;55:162
How to cite this URL:
Kumar M, Kumar M, Jha AK, Arora A, Sreepriya P P, Niroop B S, Ali MA. Author's reply: Comparative analysis of onlay and sublay (retrorectus) mesh repair for incisional hernia (width ≤10 cm) of abdominal wall: A single-center experience. Formos J Surg [serial online] 2022 [cited 2022 Aug 1];55:162. Available from: https://www.e-fjs.org/text.asp?2022/55/4/162/353061

Dear Editor,

We thank the author for his interest in our recently published article and appreciate his effort in critically analyzing it.[1]

The author proposed the questions concerning the outcome of onlay repair, the effect of preoperative variables on the outcome, the type of incisional hernia and its effect on the outcome, and subgroup analysis.

A question on the outcome of onlay repair with cited reference[2] is inconsistent with our study. However, cited reference by the author is a systemic review by Köckerling and Lammers,[2] which compared the outcome of laparoscopic intraperitoneal onlay mesh (IPOM) with open IPOM. It concluded that open IPOM is associated with significantly poorer outcomes. Moreover, our study compared the onlay technique with sublay, where the mesh position is not in the intraperitoneal location.

The systemic review of the onlay technique in incisional hernia repair by Köckerling[3] has shown that the onlay technique was associated with more wound complications but with a comparable recurrence rate compared with sublay repair. Therefore, our results were consistent with the systemic review by Köckerling.[3]

Concerning the effect of preoperative variables on the outcome, we agree that it impacts morbidity. However, the preoperative variables' matched cohort is a limitation due to the study's retrospective design.

We agree that the type of ventral hernia may affect the outcome.[4] However, we included only the incisional hernia cohort; primary paraumbilical and epigastric hernias were not part of our study.

Finally, we agree that subgroup analysis may highlight the effect of preoperative variables on morbidity. However, because of the smaller sample size in each cohort and retrospective design, subgroup analysis was not done, which is the limitation of this study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 

  References 
1.Kumar M, Kumar M, Jha AK, Arora A, Sreepriya PP, Niroop BS, et al. Comparative analysis of onlay and sublay (retrorectus) mesh repair for incisional hernia (width≤10 cm) of the abdominal wall: A single-center experience. Formos J Surg 2022;55:1-6.  
  [Full text]  2.Köckerling F, Lammers B. Open Intraperitoneal Onlay Mesh (IPOM) technique for incisional hernia repair. Front Surg 2018;5:66.  
    3.Köckerling F. Onlay technique in incisional hernia repair – A systematic review. Front Surg 2018;5:71.  
    4.Issa M, Noureldin K, Elgadi A, Abdelaziz A, Badawi M, Makram M. Evaluation of the sublay mesh repair outcomes in different types of ventral hernia. Cureus 2021;13:e20590.