How I do it: novel parastomal herniorrhaphy utilizing transversus abdominis release

Pauli, Eric M.; Juza, Ryan M.; Winder, Joshua S.

doi:10.1007/s10029-016-1489-3

Cited by 74 publications

(56 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…18 With all the popular transversus abdominis release (TAR) with mesh placement has gained for large incisional hernias, a new method of open parastomal hernia repair with retromuscular mesh reinforcement is likely to gain further popularity as it maintains the biomechanics of a functional abdominal wall and is reinforced with synthetic mesh. 19 Several alternatives to traditional open repair with mesh have been proposed. The Sugarbaker technique, in which the bowel travels between a supportive mesh flap and the peritoneum prior to the exit site, has been widely modeled.…”

Section: Parastomal Herniamentioning

confidence: 99%

Ostomy Complications in Crohn's Disease

Aboulian

2019

Clinics in Colon and Rectal Surgery

View full text Add to dashboard Cite

Ostomy creation is a routine surgical procedure that has earned its place high in the surgeon's armamentarium in dealing with challenging situations. However, it is not without its complications. In this article, we review the common complications including parastomal hernia, prolapse, mucocutaneous junction separation with ischemia and stenosis, peristomal skin conditions, and infections. Additionally, we review conditions that arise in association with underlying Crohn's disease, such as peristomal inflammation, fistula formation, and pyoderma gangrenosum.

show abstract

Section: Parastomal Herniamentioning

confidence: 99%

Ostomy Complications in Crohn's Disease

Aboulian

2019

Clinics in Colon and Rectal Surgery

View full text Add to dashboard Cite

show abstract

“…The transversus abdominis release technique can be utilized in unique hernias as well. We have found TAR to be successful for the management of parastomal hernia (or for large midline hernias occurring in patient with an ostomy adjacent to the defect) [33,34] . If the stoma does not warrant relocation, a TAR is carefully performed around the stoma as described above.…”

Section: Special Situationsmentioning

confidence: 99%

“…The bowel proximal to the stoma is delivered into the retroperitoneal plane and posterior sheath defect is closed lateralizing the bowel within the retromuscular space. Mesh is positioned around the bowel in a Sugarbaker fashion, which permits wide overlap of hernia defects without the need to cut the mesh or relocate the stoma [33] .…”

Section: Special Situationsmentioning

confidence: 99%

New perspectives in abdominal wall reconstruction: posterior component separation/transversus abdominis release

Siegal¹,

Pauli²

2019

PAR

Self Cite

View full text Add to dashboard Cite

The Rives-Stoppa technique for ventral hernia repair is commonly utilized due to well-proven outcomes with low overall morbidity. However, this approach is limited by the amount of myofascial advancement and sublay space available for a wide mesh overlap. Thus, anterior component separation was developed to allow further myofascial advancement. Some limitations were noted, which led to the subsequent study, utilization, and refinement of the posterior component separation (PCS) technique. PCS continues to demonstrate low hernia recurrence, surgical site occurrences, and improvement in rectus muscle function. Continued adoption of this technique has expanded to minimally invasive approaches for hernia repair. This paper is a comprehensive review of the evolution of PCS, technique, and outcomes.

show abstract

“…One of the technical details most difficult to determine during the laparoscopic Sugarbaker technique is a strategy for reliably fixing the mesh to construct a funnel that can hold the ostomic intestine inside not only to avoid injury and compression to the intestine but also to reduce the hernia recurrence rate. We focused on this aspect to improve the technical details of the laparoscopic Sugarbaker technique[ 5 - 7 ]. In our hospital, we applied an innovative three-point anchoring and suturing technique to fix the mesh during the laparoscopic Sugarbaker technique.…”

Section: Introductionmentioning

confidence: 99%

Modified laparoscopic Sugarbaker repair of parastomal hernia with a three-point anchoring technique

Huang

Long

Chen

et al. 2018

WJCC

View full text Add to dashboard Cite

AIMTo retrospectively evaluate the safety and feasibility of a new modified laparoscopic Sugarbaker repair in patients with parastomal hernias.METHODSA retrospective study was performed to analyze eight patients who underwent parastomal hernia repair between June 2016 and January 2018. All of these patients received modified laparoscopic Sugarbaker hernia repair treatment. This modified technique included an innovative three-point anchoring and complete suturing technique to fix the mesh. All procedures were performed by a skilled hernia surgeon. Demographic data and perioperative outcomes were collected to evaluate the safety and efficacy of this modified technique.RESULTSOf these eight patients, two had concomitant incisional hernias. All the hernias were repaired by the modified laparoscopic Sugarbaker technique with no conversion to laparotomy. Three patients had in-situ reconstruction of intestinal stoma. The median mesh size was 300 cm2, and the mean operative time was 205.6 min. The mean postoperative hospitalization time was 10.4 d, with a median pain score of 1 (visual analog scale method) at postoperative day 1. Two patients developed postoperative complications. One patient had a pocket of effusion surrounding the biologic mesh, and one patient experienced an infection around the reconstructed stoma. Both patients recovered after conservative management. There was no recurrence during the follow-up period (6-22 mo, average 13 mo).CONCLUSIONThe modified laparoscopic Sugarbaker repair could fix the mesh reliably with mild postoperative pain and a low recurrence rate. The technique is safe and feasible for parastomal hernias.

show abstract

How I do it: novel parastomal herniorrhaphy utilizing transversus abdominis release

Cited by 74 publications

References 10 publications

Ostomy Complications in Crohn's Disease

Ostomy Complications in Crohn's Disease

New perspectives in abdominal wall reconstruction: posterior component separation/transversus abdominis release

Modified laparoscopic Sugarbaker repair of parastomal hernia with a three-point anchoring technique

Contact Info

Product

Resources

About