Parastomal hernia: Local resiting and mesh repair

Abstract

A new approach for parastomal hernia repair is described that combines the simplicities of local surgery with the advantages of stomal resiting through a fresh area of the abdominal wall. Surgical technique, The stoma is mobilized about the mucocutaneous junction (Fig.

Parastomal hernia

“…Rubin et al 74 noted an incidence of 52 per cent for incisional hernia, whereas Cheung et al 46 reported an incidence of only 8 per cent. Stephenson and Phillips 78 suggested a local resiting though the abdominal wall fascia, with the addition of mesh to repair the defect at the previous stoma site. In this series three of eight patients had minor wound complications, none of which required removal of the mesh; there was no recurrence at a mean follow-up of 15 months.…”

A direct approach for the treatment of parastomal hernias using a prosthesis

“…This is not the case for the direct approach. The latter, in our estimation, must be accompanied by the insertion of a prosthesis whether it be polyester [Alexandre and Bouillot 1993, Leslie 1984, Stephenson 1995 as is our series, or polypropylene [Abdu 1982, Rosin andBonardi 1977]. In the absence of a prosthesis, recurrence rate can reach 75% [Rubin et al 1994].…”

Parastomal Hernia

“…A 2012 systematic review by Hansson et al deemed fascial repair outdated due to an overall morbidity rate of 22.6, 11.8 % surgical site infection and 69.4 % rate of recurrent PH [68]. Stoma relocation can result in recurrent PH in 0-76.2 % of patients [3,[64][65][66][69][70][71]. Stoma relocation can carry the added risk of a laparotomy and thus create three potential sites for hernia formation; however, in one series, 76 % of stoma relocation cases were successfully accomplished without a laparotomy [64].…”