Stapled Mesh stomA Reinforcement Technique (SMART) in the prevention of parastomal hernia: a single-centre experience

Abstract

Our medium-term experience has demonstrated the efficacy of SMART in the reduction of parastomal hernia occurrence. With appropriate learning curve, parastomal hernia can be prevented.

Short‐term outcomes of parastomal hernia prophylaxis with Stapled Mesh stomA Reinforcement Technique (SMART) in permanent stomas

“…Subsequently, the use of polypropylene mesh was adopted as it was permanent and cheaper. Studies that used permanent mesh also report a lower parastomal hernia rate, without significant morbidity of mesh‐related complications 19,22,23 …”

“…22 These results were in keeping with previously published randomized control trial results demonstrating that prophylactic mesh reinforcement for elective stomas reduces parastomal hernias and was cost effective. 2,14,16,17,[22][23][24] However, these studies have relatively small number of patients recruited.…”

Contemporary concepts in hernia prevention: Selected proceedings from the 2017 International Symposium on Prevention of Incisional Hernias

“…Recent reports indicate that the SMART method for stoma creation is safe and effective, with few wound complications and a significantly decreased rate of formation of parastomal hernias. 29,30 During the Symposium, a series of 16 patients whose stomas were created via the SMART method between January 2015 and September 2017 in San Camillo Hospital, Trento, Italy was presented. The average age of the cohort was 71 ± 10 years, with a mean BMI = 25 ± 4, and median follow-up was 16 ± 8 months.…”

Current Technologies for the Prevention of Parastomal Herniation (Review)

“…A similar method was tested by a group from Australia (Ng and Tan [96]); unlike Williams they used a standard circular stapling machine with a diameter of 25 and 28 mm and the Ultrapro composite mesh prosthesis. The latter was circularly fixed to the inner sheet of the abdominal straight muscle sheath.…”

“…Two patients out of 14 developed parastomal hernias (as revealed by CT); those did not require surgical treatment. There were no complications associated with the stoma [96]. The long-term results of this methodology are not presented but expected to be assessed in future studies.…”