Objective: To compare the efficacy and safety between onlay mesh technique and sublay mesh technique in patients undergoing paraumbilical hernia repair.

Study Design: Retrospective/Observational

Place & Duration: In the department of surgery, Muhammad Teaching Hospital, Peshawar and Fauji Foundation Hospital, Rawalpindi and conducted during the period from  March 2021 to August 2021.

Methods: A total of 166 patients with both genders having ages 18 to 65 years who were undergoing para-umbilical hernia repair were included. Patients demographic including age, gender were recorded after informed consent. Patients were equally divided into two groups Group O and Group S. Group O (83 patients) received onlay mesh technique and Group S (83 patients) received sublay technique. Outcomes such as post-operative pain, wound infection, seroma formation and hospital stay were recorded and compare the results between both groups.

Results: In group O 48 (57.83%) patients and in group S 47 (56.63%) patients were females while 35 (42.17%) and 36 (43.37%) patients were males in group O and S. There was significant difference in term of post-operative pain 6.01+2.26 vs 3.58+1.44 (P-value <0.05). In group O 14 (16.87%) patients and in group S 4 (4.82%) patients had wound infection. 8 (9.64%) patients in Group O and 2 (2.40%) patients in Group S had seroma. Mean Hospital stay in days was high in Group O compared to Group B 5.32+1.74 vs 2.46+1.38 days (p=<0.05). There was a statistical significant difference regarding efficacy between both procedures with p-value 0.036.

Conclusion: We concluded that sublay mesh technique for para-umbilical hernia repair was safe and effective with very low rate of complications as compared to onlay mesh procedure.

Keywords: Paraumbilical Hernia Repair, Onlay Mesh Technique, Sublay Mesh Technique, Outcomes.