Skip to main content
SpringerLink
Log in

Laparoscopic Parastomal Hernia Repair

  • Chapter
  • First Online:
Hernia Surgery

  • 4820 Accesses

Abstract

Parastomal hernias are a common and challenging occurrence after stoma creation. There is no universally agreed upon classification system. Many risk factors for parastomal hernia are not modifiable. Imaging can serve as an adjunct to a history and physical exam in diagnosing parastomal hernia. Complications can vary in severity and may warrant operative intervention. Operative approach can be open or laparoscopic, but mesh repairs are preferred to non-mesh repairs. It is our preference to perform a laparoscopic modified Sugarbaker technique for both initial and recurrent parastomal hernias. Prophylactic mesh placement at the time of stoma creation has been shown to decrease rates of parastomal hernia development without increasing the rate of infectious complications.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Janes A, Cengiz Y, Israelsson LA. Randomized clinical trial of the use of a prosthetic mesh to prevent parastomal hernia. Br J Surg. 2004;91(3):280–2.

    Article  CAS  PubMed  Google Scholar 

  2. Smietanski M, Szczepkowski M, Alexandre JA, Berger D, Bury K, Conze J, et al. European Hernia Society classification of parastomal hernias. Hernia. 2013;18(1):1–6.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Rubin MS, Schoetz Jr DJ, Matthews JB. Parastomal hernia. Is stoma relocation superior to fascial repair? Arch Surg. 1994;129(4):413–8. discussion 8–9.

    Article  CAS  PubMed  Google Scholar 

  4. Devlin HB, Kingsnorth AN. Management of abdominal hernias. London: Hodder Arnold; 1998.

    Google Scholar 

  5. Moreno-Matias J, Serra-Aracil X, Darnell-Martin A, Bombardo-Junca J, Mora-Lopez L, Alcantara-Moral M, et al. The prevalence of parastomal hernia after formation of an end colostomy. A new clinico-radiological classification. Colorectal Dis. 2009;11(2):173–7.

    Article  CAS  PubMed  Google Scholar 

  6. Gil G, Owski MS. A new classification of parastomal hernias—from the experience at Bielanski Hospital in Warsaw. Pol Przegl Chir. 2011;83(8):430–7.

    PubMed  Google Scholar 

  7. Sohn YJ, Moon SM, Shin US, Jee SH. Incidence and risk factors of parastomal hernia. J Kor Soc Coloproctol. 2012;28(5):241–6.

    Article  Google Scholar 

  8. Hong SY, Oh SY, Lee JH, Kim do Y, Suh KW. Risk factors for parastomal hernia: based on radiological definition. J Korean Surg Soc. 2013;84(1):43–7.

    Article  PubMed  Google Scholar 

  9. Leong AP, Londono-Schimmer EE, Phillips RK. Life-table analysis of stomal complications following ileostomy. Br J Surg. 1994;81(5):727–9.

    Article  CAS  PubMed  Google Scholar 

  10. Londono-Schimmer EE, Leong AP, Phillips RK. Life table analysis of stomal complications following colostomy. Dis Colon Rectum. 1994;37(9):916–20.

    Article  CAS  PubMed  Google Scholar 

  11. Pilgrim CH, McIntyre R, Bailey M. Prospective audit of parastomal hernia: prevalence and associated comorbidities. Dis Colon Rectum. 2010;53(1):71–6.

    Article  PubMed  Google Scholar 

  12. Ripoche J, Basurko C, Fabbro-Perray P, Prudhomme M. Parastomal hernia. A study of the French federation of ostomy patients. J Visc Surg. 2011;148(6):e435–41.

    Article  CAS  PubMed  Google Scholar 

  13. Schreinemacher MH, Vijgen GH, Dagnelie PC, Bloemen JG, Huizinga BF, Bouvy ND. Incisional hernias in temporary stoma wounds: a cohort study. Arch Surg. 2011;146(1):94–9.

    Article  PubMed  Google Scholar 

  14. De Raet J, Delvaux G, Haentjens P, Van Nieuwenhove Y. Waist circumference is an independent risk factor for the development of parastomal hernia after permanent colostomy. Dis Colon Rectum. 2008;51(12):1806–9.

    Article  PubMed  Google Scholar 

  15. Carne PW, Frye JN, Robertson GM, Frizelle FA. Parastomal hernia following minimally invasive stoma formation. ANZ J Surg. 2003;73(10):843–5.

    Article  PubMed  Google Scholar 

  16. Sorensen LT, Hemmingsen U, Kallehave F, Wille-Jorgensen P, Kjaergaard J, Moller LN, et al. Risk factors for tissue and wound complications in gastrointestinal surgery. Ann Surg. 2005;241(4):654–8.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Carlstedt A, Fasth S, Hulten L, Nordgren S, Palselius I. Long-term ileostomy complications in patients with ulcerative colitis and Crohn’s disease. Int J Colorectal Dis. 1987;2(1):22–5.

    Article  CAS  PubMed  Google Scholar 

  18. Carne PW, Robertson GM, Frizelle FA. Parastomal hernia. Br J Surg. 2003;90(7):784–93.

    Article  CAS  PubMed  Google Scholar 

  19. Rullier E, Le Toux N, Laurent C, Garrelon JL, Parneix M, Saric J. Loop ileostomy versus loop colostomy for defunctioning low anastomoses during rectal cancer surgery. World J Surg. 2001;25(3):274–7. discussion 7–8.

    Article  CAS  PubMed  Google Scholar 

  20. Helgstrand F, Rosenberg J, Kehlet H, Jorgensen LN, Wara P, Bisgaard T. Risk of morbidity, mortality, and recurrence after parastomal hernia repair: a nationwide study. Dis Colon Rectum. 2013;56(11):1265–72.

    Article  PubMed  Google Scholar 

  21. Israelsson LA. Preventing and treating parastomal hernia. World J Surg. 2005;29(8):1086–9.

    Article  PubMed  Google Scholar 

  22. Janes A, Cengiz Y, Israelsson LA. Preventing parastomal hernia with a prosthetic mesh: a 5-year follow-up of a randomized study. World J Surg. 2009;33(1):118–21. discussion 22–3.

    Article  PubMed  Google Scholar 

  23. Rieger N, Moore J, Hewett P, Lee S, Stephens J. Parastomal hernia repair. Colorectal Dis. 2004;6(3):203–5.

    Article  CAS  PubMed  Google Scholar 

  24. Cingi A, Cakir T, Sever A, Aktan AO. Enterostomy site hernias: a clinical and computerized tomographic evaluation. Dis Colon Rectum. 2006;49(10):1559–63.

    Article  PubMed  Google Scholar 

  25. Gurmu A, Matthiessen P, Nilsson S, Pahlman L, Rutegard J, Gunnarsson U. The inter-observer reliability is very low at clinical examination of parastomal hernia. Int J Colorectal Dis. 2011;26(1):89–95.

    Article  PubMed  Google Scholar 

  26. Gurmu A, Gunnarsson U, Strigard K. Imaging of parastomal hernia using three-dimensional intrastomal ultrasonography. Br J Surg. 2011;98(7):1026–9.

    Article  CAS  PubMed  Google Scholar 

  27. Smietanski M, Bury K, Matyja A, Dziki A, Wallner G, Studniarek M, et al. Polish guidelines for treatment of patients with parastomal hernia. Pol Przegl Chir. 2013;85(3):152–80.

    PubMed  Google Scholar 

  28. Burgess P, Matthew V, Devlin H. A review of terminal colostomy complications following abdominoperineal resection for carcinoma. Br J Surg. 1984;71:1004.

    Google Scholar 

  29. Burns F. Complications of colostomy. Dis Colon Rectum. 1970;13:448–50.

    Article  CAS  PubMed  Google Scholar 

  30. Rolstad BS, Boarini J. Principles and techniques in the use of convexity. Ostomy Wound Manage. 1996;42(1):24–6. 8–32; quiz 3–4.

    CAS  PubMed  Google Scholar 

  31. Armstrong E. Practical aspects of stoma care. Nurs Times. 2001;97(12):40–2.

    CAS  PubMed  Google Scholar 

  32. Kane M, McErlean D, McGrogan M, Thompson MJ, Haughey S. Clinical protocols for stoma care: 6. Management of parastomal hernia. Nurs Stand. 2004;18(19):43–4.

    Article  PubMed  Google Scholar 

  33. Berger D, Bientzle M. Laparoscopic repair of parastomal hernias: a single surgeon’s experience in 66 patients. Dis Colon Rectum. 2007;50(10):1668–73.

    Article  PubMed  Google Scholar 

  34. Hansson BM, Slater NJ, van der Velden AS, Groenewoud HM, Buyne OR, de Hingh IH, et al. Surgical techniques for parastomal hernia repair: a systematic review of the literature. Ann Surg. 2012;255(4):685–95.

    Article  PubMed  Google Scholar 

  35. Sugarbaker PH. Peritoneal approach to prosthetic mesh repair of paraostomy hernias. Ann Surg. 1985;201(3):344–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Bayer I, Kyzer S, Chaimoff C. A new approach to primary strengthening of colostomy with Marlex mesh to prevent paracolostomy hernia. Surg Gynecol Obstet. 1986;163(6):579–80.

    CAS  PubMed  Google Scholar 

  37. Figel NA, Rostas JW, Ellis CN. Outcomes using a bioprosthetic mesh at the time of permanent stoma creation in preventing a parastomal hernia: a value analysis. Am J Surg. 2012;203(3):323–6. discussion 6.

    Article  PubMed  Google Scholar 

  38. Gogenur I, Mortensen J, Harvald T, Rosenberg J, Fischer A. Prevention of parastomal hernia by placement of a polypropylene mesh at the primary operation. Dis Colon Rectum. 2006;49(8):1131–5.

    Article  PubMed  Google Scholar 

  39. Martinek L, Dostalik J, Gunkova P, Gunka I, Mazur M. Prevention of parastomal hernia using laparoscopic introduction of a prosthetic mesh--initial experience. Rozhl Chir. 2012;91(4):216–8.

    CAS  PubMed  Google Scholar 

  40. Nagy A, Kovacs T, Bognar J, Mohos E, Loderer Z. Parastomal hernia repair and prevention with PHSL type mesh after abdomino-perineal rectum extirpation. Zentralbl Chir. 2004;129(2):149–52.

    Article  CAS  PubMed  Google Scholar 

  41. Marimuthu K, Vijayasekar C, Ghosh D, Mathew G. Prevention of parastomal hernia using preperitoneal mesh: a prospective observational study. Colorectal Dis. 2006;8(8):672–5.

    Article  CAS  PubMed  Google Scholar 

  42. Vijayasekar C, Marimuthu K, Jadhav V, Mathew G. Parastomal hernia: Is prevention better than cure? Use of preperitoneal polypropylene mesh at the time of stoma formation. Tech Coloproctol. 2008;12(4):309–13.

    Article  CAS  PubMed  Google Scholar 

  43. Lee L, Saleem A, Landry T, Latimer E, Chaudhury P, Feldman LS. Cost effectiveness of mesh prophylaxis to prevent parastomal hernia in patients undergoing permanent colostomy for rectal cancer. J Am Coll Surg. 2013;29.

    Google Scholar 

  44. Lopez-Cano M, Lozoya-Trujillo R, Quiroga S, Sanchez JL, Vallribera F, Marti M, et al. Use of a prosthetic mesh to prevent parastomal hernia during laparoscopic abdominoperineal resection: a randomized controlled trial. Hernia. 2012;16(6):661–7.

    Article  CAS  PubMed  Google Scholar 

  45. Hammond TM, Huang A, Prosser K, Frye JN, Williams NS. Parastomal hernia prevention using a novel collagen implant: a randomised controlled phase 1 study. Hernia. 2008;12(5):475–81.

    Article  CAS  PubMed  Google Scholar 

  46. Janes A, Cengiz Y, Israelsson LA. Preventing parastomal hernia with a prosthetic mesh. Arch Surg. 2004;139(12):1356–8.

    Article  PubMed  Google Scholar 

  47. Serra-Aracil X, Bombardo-Junca J, Moreno-Matias J, Darnell A, Mora-Lopez L, Alcantara-Moral M, et al. Randomized, controlled, prospective trial of the use of a mesh to prevent parastomal hernia. Ann Surg. 2009;249(4):583–7.

    Article  PubMed  Google Scholar 

  48. Sajid MS, Kalra L, Hutson K, Sains P. Parastomal hernia as a consequence of colorectal cancer resections can prophylactically be controlled by mesh insertion at the time of primary surgery: a literature based systematic review of published trials. Minerva Chir. 2012;67(4):289–96.

    CAS  PubMed  Google Scholar 

  49. Shabbir J, Chaudhary BN, Dawson R. A systematic review on the use of prophylactic mesh during primary stoma formation to prevent parastomal hernia formation. Colorectal Dis. 2012;14(8):931–6.

    Article  CAS  PubMed  Google Scholar 

  50. Tam KW, Wei PL, Kuo LJ, Wu CH. Systematic review of the use of a mesh to prevent parastomal hernia. World J Surg. 2010;34(11):2723–9.

    Article  PubMed  Google Scholar 

  51. Fleshman JW, Beck DE, Hyman N, Wexner SD, Bauer J, George V, PRISM Study Group. A prospective, multicenter, randomized, controlled study of non-cross-linked porcine acellular dermal matrix fascial sublay for parastomal reinforcement in patients undergoing surgery for permanent abdominal wall ostomies. Dis Colon Rectum. 2014;57(5):623–31.

    Article  PubMed  Google Scholar 

  52. Mancini GJ, McClusky 3rd DA, Khaitan L, Goldenberg EA, Heniford BT, Novitsky YW, et al. Laparoscopic parastomal hernia repair using a nonslit mesh technique. Surg Endosc. 2007;21(9):1487–91.

    Article  CAS  PubMed  Google Scholar 

  53. McLemore EC, Harold KL, Efron JE, Laxa BU, Young-Fadok TM, Heppell JP. Parastomal hernia: short-term outcome after laparoscopic and conventional repairs. Surg Innov. 2007;14(3):199–204.

    Article  PubMed  Google Scholar 

  54. Craft RO, Huguet KL, McLemore EC, Harold KL. Laparoscopic parastomal hernia repair. Hernia. 2008;12(2):137–40.

    Article  CAS  PubMed  Google Scholar 

  55. Berger D, Bientzle M. Polyvinylidene fluoride: a suitable mesh material for laparoscopic incisional and parastomal hernia repair! A prospective, observational study with 344 patients. Hernia. 2009;13(2):167–72.

    Article  CAS  PubMed  Google Scholar 

  56. Hansson BM, de Hingh IH, Bleichrodt RP. Laparoscopic parastomal hernia repair is feasible and safe: early results of a prospective clinical study including 55 consecutive patients. Surg Endosc. 2007;21(6):989–93.

    Article  CAS  PubMed  Google Scholar 

  57. Hansson BM, Bleichrodt RP, de Hingh IH. Laparoscopic parastomal hernia repair using a keyhole technique results in a high recurrence rate. Surg Endosc. 2009;23(7):1456–9.

    Article  CAS  PubMed  Google Scholar 

  58. Liu F, Li J, Wang S, Yao S, Zhu Y. Effectiveness analysis of laparoscopic repair of parastomal hernia using CK Parastomal patch. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2011;25(6):681–4.

    PubMed  Google Scholar 

  59. Wara P, Andersen LM. Long-term follow-up of laparoscopic repair of parastomal hernia using a bilayer mesh with a slit. Surg Endosc. 2011;25(2):526–30.

    Article  PubMed  Google Scholar 

  60. Mizrahi H, Bhattacharya P, Parker MC. Laparoscopic slit mesh repair of parastomal hernia using a designated mesh: long-term results. Surg Endosc. 2012;26(1):267–70.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of General Surgery, Mayo Clinic Arizona, 5779 E Mayo Boulevard, MCSB SP 3-522 Gen Surg, Phoenix, AZ, 85054, USA

    Erin M. Garvey M.D. & Kristi L. Harold M.D.

Authors
  1. Erin M. Garvey M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kristi L. Harold M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kristi L. Harold M.D. .

Editor information

Editors and Affiliations

  1. Case Comprehensive Hernia Center, University Hospitals Case Medical Center, Cleveland, Ohio, USA

    Yuri W. Novitsky

Electronic Supplementary Material

Laparoscopic Parastomal (Sugarbaker) repair, by Harold (WMV 137,831 kb)

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Garvey, E.M., Harold, K.L. (2016). Laparoscopic Parastomal Hernia Repair. In: Novitsky, Y. (eds) Hernia Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-27470-6_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-27470-6_23

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-27468-3

  • Online ISBN: 978-3-319-27470-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation