Laparoscopic treatment of parastomal hernia and concomitant midline incisional hernia
Epublication WebSurg.com, Jul 2015;15(07). URL: http://websurg.com/doi/vd01en4523
An individual approach to the treatment of patients with incisional hernia is essential. The objective of this video is to demonstrate the advantages of a laparoscopic parastomal hernia repair in a selected patient. This video demonstrates the case of a 61-year-old female patient (BMI of 28.4 kg/m2) with a huge parastomal hernia compromising the stoma care, and with a suspected midline incisional hernia. After a complete adhesiolysis, we were able to detect and measure both abdominal wall defects. After narrowing the parastomal defect, a local hernioplasty was performed by applying the Sugarbaker technique with a Parietex™ Parastomal Mesh (PCOPM15). For a midline incisional hernia, we used a Parietex™ composite mesh (PPC1510). Both prostheses were fixed to the abdominal wall with transfascial sutures and tacks (ProTack™). Both operative and postoperative periods were uneventful. The laparoscopic treatment of a parastomal hernia should be considered as a first option because it endeavors to join the advantages of a minimally invasive approach with a low incidence of infection and recurrence rate, and offers the opportunity of repairing a concomitant incisional hernia, if present.