Abdominal wall: incisional hernia repair: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Abdominal wall: incisional hernia repair

Sample item

A surgeon repairs a large midline incisional hernia using mesh. Which mesh position is associated with the lowest recurrence?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Sublay (retromuscular, preperitoneal) position

In the sublay (Rives-Stoppa) position the mesh lies behind the rectus muscles, and intra-abdominal pressure pushes it against the abdominal wall, which improves fixation and reduces recurrence and infection. Onlay placement has more seroma and wound problems, and bridging a defect without closing it has the highest recurrence.

Option by option

  • A. Inlay bridging within the defect

    Inlay bridging relies on suture-to-mesh fixation and has a high recurrence rate.

  • B. Onlay position over the anterior sheath

    Onlay mesh sits in the subcutaneous plane with more seroma, infection and recurrence.

  • C. Sublay (retromuscular, preperitoneal) position (correct)

    Correct. Retromuscular placement uses abdominal pressure to hold mesh and has the best outcomes.

  • D. Placement within the subcutaneous fat

    The subcutaneous fat provides no fascial support for the mesh to hold.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Sublay (retromuscular, preperitoneal) position. In the sublay (Rives-Stoppa) position the mesh lies behind the rectus muscles, and intra-abdominal pressure pushes it against the abdominal wall, which improves fixation and reduces recurrence and infection.

Why is "Inlay bridging within the defect" not the answer?

Inlay bridging relies on suture-to-mesh fixation and has a high recurrence rate.

Why is "Onlay position over the anterior sheath" not the answer?

Onlay mesh sits in the subcutaneous plane with more seroma, infection and recurrence.

Why is "Placement within the subcutaneous fat" not the answer?

The subcutaneous fat provides no fascial support for the mesh to hold.

What concept does this question test?

It tests Abdominal wall: incisional hernia repair in General Surgery. Onlay placement has more seroma and wound problems, and bridging a defect without closing it has the highest recurrence.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Abdominal wall: incisional hernia repair?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.