Department of Surgery, Kirkuk General Hospital


Introducion&Objectives: Ventral hernia of both types spontaneous & incisional are commonly encountered in surgical practice. Despite the frequency of surgical repair, perfect results continue to elude surgeons & the rate of surgical failure may approach 10- 30%. Nowadays meshplasty is regarded as ideal procedure for hernia repair & actually primary suture repair is abandoned except for hernia with defect size of less than 2.5cm.Different types of mesh used for repair &different sites of placement described including onlay, inlay, sublay & sandwich pattern with different results. Aim of this study is to evaluate meshplasty in ventral &incisional hernia &to compare between onlay &inlay techniques in regard of operative ease, time, early& late postoperative complications. 
Design: Prospective comparative study. 
Patients and Methods: This study was conducted on (60) patients with ventral &incisional hernia admitted to surgical department of Kirkuk general hospital between the periods Feb-2010 to Feb-2013. All patients were grouped randomly into two groups: Group (1) including (30) patients with onlay meshplasty &Group (2) including (30) patients with inlay technique. 
Results: The age of the patients was ranged (22-75) years with mean age of (48.5) years. Most of the patients were at fourth decade (48.3%) (n=29). (70%) of all patients (n=42) were females & (30%) of them (n=18) were males. (66.6%) of all patients (n=40) had incisional hernia & (33.3%) of patients with spontaneous hernia (n=20). The operative time in patients of Group (1) onlay technique was (60-100) minutes compared to (50-80) minutes in patients of Group (2) inlay technique. (3) Patients (10%) of Onlay Group developed seroma, (2) patients (6.6%) had deep wound infection. None of all patients of either group had sinus or enterocutanous fistula. (4)patients(13.3%) of Onlay Group had recurrence of their hernia during(12)months period follow up but only one patient (3.3%) of Inlay Group developed recurrence during same period of follow up. 
Conclusion:-Inlay meshplasty for repair of ventral abdominal hernia is more effective& gives better results in regard of operative ease, time, early &postoperative complications.