ABSTRACT
Background: In the last few decades mesh repair of hernia became the standard treatment in all types of hernia including Paraumbilical hernia(PUH), position of mesh placement either onlay or sublay still an issue of debate, in this study we trying to address advantages and disadvantages of each position.
Patients and methods: In this study we recruited 32 patients with Paraumbilical hernia, patients were randomly allocated according to mesh placement position into sublay group 16 patients and onlay group 16 patients, preoperative, operative and follow up data of all participants were properly presented and analyzed using the suitable statistical tests.
Results: The mean operative time in the sublay group was 111.9 minutes, while in the onlay group it was 85.6. Hospital stay in the onlay group was significantly longer compared to the onlay group (p=0.03). Duration for drain removal was significantly shorter in sublay group. post-operative complications in the form of superficial wound infection occurred in 4 patients of the onlay group and only 2 cases of the sublay group, seroma formation occurred in 3 patients of the onlay group & 2 patients of the sublay group, While post-operative chest infection was encountered in 1 patient of the sublay group, No incidence of recurrence was recorded from both groups during the 6 month follow up.

Conclusion:Both sublay and onlay mesh placement techniques are safe, both produced acceptable results, and are associated with comparable complications and recurrence rates.