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Open Access 28-04-2024 | Enterostomy | How-I-Do-It

Parastomal hernia repair, trying to optimize the impossible reconstruction

Authors: S. M. Maskal, R. C. Ellis, B. T. Miller

Published in: Hernia

Abstract

Purpose

Parastomal hernias are a common and challenging problem with high rates of wound complications and hernia recurrence after repair. We present our approach to optimizing parastomal hernia repair through preoperative preparation, surgical approach, and postoperative management.

Methods

Patients are carefully evaluated and optimized prior to surgery. Our typical surgical approach involves a generous midline laparotomy and retrorectus dissection followed by a posterior component separation with transversus abdominis release. We typically utilize a Sugarbaker technique for retromuscular mesh placement but also use the retromuscular keyhole or cruciate technique if there is insufficient bowel length.

Results

Previously published results from our institution include wound complication rates of up to 16% after open retromuscular parastomal hernia repair. Stoma-specific complications, such as mesh erosion in the bowel, may be attributed to the mesh placement techniques. Hernia recurrence rates range from 11 to 30% up to 2 years postoperatively.

Conclusion

We prefer an open retromuscular approach with a Sugarbaker mesh configuration to treat complex parastomal hernias. However, wound morbidity and repair failure rates remain high, and additional research is needed to optimize surgical outcomes.

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Title: Parastomal hernia repair, trying to optimize the impossible reconstruction
Authors: S. M. Maskal
R. C. Ellis
B. T. Miller
Publication date: 28-04-2024
Publisher: Springer Paris
Keywords: Enterostomy
Enterostomy
Parastomale Hernie
Published in: Hernia
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-024-03041-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Parastomal hernia repair, trying to optimize the impossible reconstruction

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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