Laparoscopic parastomal hernia repair

R. O. Craft, K. L. Huguet, E. C. McLemore, Kristi L. Harold

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Background: Management of the parastomal hernia represents a common clinical dilemma for both the surgeon and patient. Once established, these defects are notoriously difficult to treat. Although most parastomal hernias can be managed nonoperatively, approximately 30% will require intervention secondary to complications such as obstruction, pain, bleeding, poorly fitting appliances, or leakage. Overall complication rates of up to 88%, combined with a growing body of literature citing decreased patient morbidity and improved outcomes with laparoscopic tension-free mesh repair of ventral hernias, have led many surgeons to apply these techniques to this difficult problem. Methods: This was a retrospective review of 21 consecutive patients who underwent laparoscopic repair of their parastomal hernias with ePTFE mesh. Results: Nine (43%) were ileal conduits, seven (33%) were ileostomies, and five (24%) were colostomies. Eight patients had undergone prior hernia repair. Follow-up ranges from 1 to 36 months (average 14 months). There has been one recurrence (5%). Other complications included laparoscopic re-operation for obstruction of a urinary conduit (n = 1), mesh removal for infection (n = 2), Clostridium Difficile colitis (n = 1), pneumonia (n = 2), renal failure (n = 1), surgical site infection (n = 1), and bowel obstruction at a site remote from the hernia repair (n = 2). Conclusion: The laparoscopic approach to parastomal hernias is a new technique that offers many potential advantages over conventional open repairs. Based on our initial experience, this repair seems to be associated with a low recurrence rate.

Original languageEnglish (US)
Pages (from-to)137-140
Number of pages4
JournalHernia
Volume12
Issue number2
DOIs
StatePublished - Apr 2008

Fingerprint

Herniorrhaphy
Hernia
Ventral Hernia
Surgical Wound Infection
Recurrence
Ileostomy
Urinary Diversion
Colostomy
Clostridium difficile
Colitis
Renal Insufficiency
Pneumonia
Hemorrhage
Morbidity
Pain
Infection
Surgeons

Keywords

  • ePTFE
  • Hernia
  • Laparoscopy
  • Parastomal

ASJC Scopus subject areas

  • Surgery

Cite this

Craft, R. O., Huguet, K. L., McLemore, E. C., & Harold, K. L. (2008). Laparoscopic parastomal hernia repair. Hernia, 12(2), 137-140. https://doi.org/10.1007/s10029-007-0299-z

Laparoscopic parastomal hernia repair. / Craft, R. O.; Huguet, K. L.; McLemore, E. C.; Harold, Kristi L.

In: Hernia, Vol. 12, No. 2, 04.2008, p. 137-140.

Research output: Contribution to journalArticle

Craft, RO, Huguet, KL, McLemore, EC & Harold, KL 2008, 'Laparoscopic parastomal hernia repair', Hernia, vol. 12, no. 2, pp. 137-140. https://doi.org/10.1007/s10029-007-0299-z
Craft RO, Huguet KL, McLemore EC, Harold KL. Laparoscopic parastomal hernia repair. Hernia. 2008 Apr;12(2):137-140. https://doi.org/10.1007/s10029-007-0299-z
Craft, R. O. ; Huguet, K. L. ; McLemore, E. C. ; Harold, Kristi L. / Laparoscopic parastomal hernia repair. In: Hernia. 2008 ; Vol. 12, No. 2. pp. 137-140.
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