Mesh placement in ventral hernia repair

Abdominal wall reconstruction is a relevant and important topic not only in plastic and reconstructive surgery, but in the practice of general surgeons. The ideal anatomic location for mesh placement during the repair of ventral hernias has been debated; however, the most common anatomic locations include onlay, inlay, sublay-retromuscular, sublaypreperitoneal, and sublay-intraperitoneal techniques (Alimi)


“Analysis of 51 articles showed that, of the four mesh techniques, namely onlay, interposition, sublay-retromuscular, and sublay-preperitoneal/sublay-peritoneal, the sublay-retromuscular approach is associated with the lowest recurrence rate, whereas the interposition technique is associated with the highest recurrence rate. There was no statistical difference in other complication rates among the four groups, which included postoperative infection, hematoma/seroma formation, mesh explantation, and mortality. Overwhelmingly, the inlay placement of mesh is the least favored and should be avoided if possible.” (Alimi)

Alimi Y, et al Mesh and plane selection: a summary of options and outcomes.
Plast Aesthet Res 2020;7:5

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