Laparoscopic parastomal hernia repair

Abstract

The laparoscopic approach to parastomal hernias is a new technique that offers many potential advantages over conventional open repairs. Based on our initial experience, this repair seems to be associated with a low recurrence rate.

Long-term follow-up of laparoscopic repair of parastomal hernia using a bilayer mesh with a slit

“…Controversy remains on whether to use mesh with a slit and keyhole or a mesh without a slit. After the first case reports of the modified Sugarbaker technique [5,7], acceptable low recurrence rates have been reported, but the length of follow-up was relatively short or was not stated [10,[13][14][15]. In another study that used the Sugarbaker technique with PTFE mesh, there were 8 recurrences in 41 patients [12].…”

“…The first reports on use of mesh with a slit were also promising [6,8,9,11,15], but recently published results have been less satisfactory with higher failure rates [14,19,20]. In a retrospective study, Muysoms et al [14] reported 8 recurrences in 11 patients repaired with the keyhole technique, but only 2 recurrences in the subsequent 13 patients after changing to the Sugarbaker technique.…”

“…Open mesh repair, with the mesh in an on-lay position or placed intraperitoneally, appears to confer a lower recurrence rate [2,3] but has a significant risk of mesh-related morbidity [2,4]. Following the first anecdotal reports [5][6][7][8][9], there is accumulating evidence that laparoscopic mesh repair is feasible and has promise in the management of parastomal hernia [10][11][12][13][14][15].…”

Korrektur der parastomalen Hernie mit Netz

“…B. Schweine hautkollagen oder humane azelluläre der male Matrix; außer Einzelbeschreibun gen existieren aber noch keine größeren in randomisierten Studien gewonnenen Erfahrungen [27,28]. Die Rezidivrate bei Verwendung der ZweiKomponentenNetze ist nach der Literatur und nach unseren Erfahrungen gering zwischen 0 und 7% [15,17,29,30]. In Einzelserien vor allem bei laparoskopi scher Anwendung werden jedoch auch hohe Rezidivraten zwischen 46 und 56% angegeben [31,32].…”

“…Die Angaben bzgl. Komplikationen wie Wundinfekte, Sepsis, Pneumonie oder Ileus schwanken erheb lich und liegen zwischen 3 und 33%, Ad häsionen, Arrosionen oder Fisteln wur den nicht beschrieben [29,30,31,32].…”