Laparoscopic parastomal hernia repair: a description of the technique and initial results.
In this study, the authors review their initial results with the laparoscopic approach for parastomal hernia repair. Between 2006 and 2007, 4 patients were treated laparoscopically at our institution. The hernia sac was not excised. A piece of Gore-Tex DualMesh with a central keyhole and a radial incision was cut so that it could provide at least 3 to 5 cm of overlap of the fascial defect. The mesh was secured to the margins of the hernia with circumferential metal tacking and trans-fascial sutures. No complications occurred in the postoperative period. After a median follow-up of 9 months, recurrence occurred in 1 patient. This was our first patient in whom mesh fixation was performed only with circumferential metal tacking. The laparoscopic repair of parastomal hernias seems to be a safe, feasible and promising technique offering the advantages of minimally-invasive surgery. The success of this approach depends on longer follow-up reports and standardization of the technical elements.
Zacharakis
Emmanouil
E
Department of Biosurgery and Surgical Technology, Imperial College London, St Mary's Hospital, London, United Kingdom. e.zacharakis@imperial.ac.uk
Hettige
Roland
R
Purkayastha
Sanjay
S
Aggarwal
Rajesh
R
Athanasiou
Thanos
T
Darzi
Ara
A
Ziprin
Paul
P
D000368:Aged; D000369:Aged, 80 and over; D003125:Colostomy; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013526:Surgical Mesh; D013536:Suture Techniques; D016896:Treatment Outcome