overlay

Many surgeons utilize the simple overlay repair as a "tension free" ventral hernia repair. The defect is dissected free from the hernia sack, and the size and shape of the defect is measured. An identical size and shape of mesh is fitted to this defect and then the mesh is sutured, usually in a running fashion, to the edge of the defect. The adipose and skin is closed over the mesh, occasionally with a closed suction drain. The hernia sack is usually opened and adhesions to bowel freed and the peritoneum reconstructed under the mesh. There are specialized two-sided mesh products that have been created that solve the common problem of inadequate peritoneum for closure; the mesh has a non-adherent side to face the bowel, and a textured side to allow incorporation into the scar that forms with the adipose layer.

Another popular method of Overlay mesh repair is to place the mesh directly over the fascia after a direct suture repair. The mesh is in direct contact with the external side of the superficial fascia that may or may not be sutured down to that fascia. The adipose and skin are then closed over the mesh.

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