Laparoscopic Paraostomal Hernia Repair: indications, technique, and results

Abstract

Parastomal hernias are defined as fascial defects around enterostomies such as colo- or ileostomies. Also the creation of urological conduits can be complicated by parastomal herniation. Whereas the repair of incisional hernias is recommended whenever such a hernia can be detected and the hernia is growing or hurts the indication for surgical repair of parastomal hernias is much more restrictive (1). Only about 30% of patients with parastomal hernias undergo surgical repair. Today a rapidly growing and symptomatic parastomal hernia should be corrected. Symptoms may be problems with defecation especially in patients which use irrigation for controlled evacuation as well as problems concerning the stoma care. An emergency indication is represented by incarceration. The great number of patients who do not need surgical repair according to todays official opinion is clearly based on the lack of a safe and effective reparation principle. Conventional procedures result in sometimes more than 50% recurrence rate and local infections up to 30% (2–5).