title: New minimally invasive technique of parastomal hernia repair - methods and review.
abstract: BACKGROUND
  Parastomal hernia is described as the most common complication in patients with ostomy. It is reported that its incidence varies from 3% to 39% for colostomies and 0 to 6% for ileostomies. Surgical repair remains the treatment of choice. There are three types of surgical treatment - fascial repair, stoma relocation and repair using prosthetic mesh via a laparoscopic or open approach. Recently there have been several meta-analyses and systematic reviews aiming to compare the results of surgical treatment, and the authors agreed that the quality of evidence precludes firm conclusions.
  
  
  OBJECTIVE
  To describe the novel concept of parastomal hernia repair - HyPER/SPHR technique (hybrid parastomal endoscopic re-do/Szczepkowski parastomal hernia repair) and its early results in 12 consecutive cases.
  
  
  METHODS
  Twelve consecutive patients were operated on due to parastomal hernia using the new HyPER hybrid technique between June 2013 and May 2014. The patients' condition was evaluated during the perioperative period, 6 weeks and then every 3 months after surgery.
  
  
  RESULTS
  After 6 weeks of follow-up we have not observed any mesh-related complications. All 12 patients were examined 3 months and 6 months after repair surgery for evaluation. No recurrence, stoma site infection or stoma-related problems were found. None of the patients complained of pain and none of them needed to be hospitalized again. Reported quality of life on a 0-10 scale after 6 weeks of follow-up was 8 (range: 7-10).
  
  
  CONCLUSIONS
  The HyPER procedure for treatment of parastomal hernias proposed by the authors is a safe and feasible surgical technique with a high patient satisfaction rate and a low number of complications. The hybrid procedure seems to be a promising method for parastomal hernia repair.
authors.affiliation: Clinical Department of General and Colorectal Surgery, Bielanski Hospital, Warsaw, Poland ; Department of Rehabilitation, Józef Piłsudski University of Physical Education, Warsaw, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Szczepkowski
authors.affiliation: Clinical Department of General and Colorectal Surgery, Bielanski Hospital, Warsaw, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Skoneczny
authors.affiliation: Clinical Department of General and Colorectal Surgery, Bielanski Hospital, Warsaw, Poland.
authors.forename: Alicja
authors.initials: A
authors.lastname: Przywózka
authors.affiliation: Clinical Department of General and Colorectal Surgery, Bielanski Hospital, Warsaw, Poland ; Department of Rehabilitation, Józef Piłsudski University of Physical Education, Warsaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Czyżewski
authors.affiliation: Department of Cardiac and Vascular Surgery, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Kamil
authors.initials: K
authors.lastname: Bury
keywords: hernia; laparoscopic; minimally invasive; parastomal; technique