Modified laparoscopic keyhole plus repair to manage a parastomal hernia: A single‐center experience

• Published in: Asian journal of endoscopic surgery 2020-01, Vol.13 (1), p.77-82
• Main Authors: Rajapandian, Subbiah, Jankar, Samrat V., Kakkilaya, Harish, Sabnis, Sandeep, Ramkrishana, Parathasarthi, Palanivelu, Praveenraj, Chinnusamy, Palanivelu
• Format: Article
• Language: English
• Subjects: Hernias; keyhole plus repair; Laparoscopy; Ostomy; parastomal hernia; stoma complications; Surgical outcomes
• ISSN: 1758-5902; 1758-5910
• DOI: 10.1111/ases.12686

Introduction Parastomal hernia (PH) is a common late complication of stoma formation for which laparoscopic repair is a well‐accepted modality of treatment. Keyhole repair has been frequently reported with recurrence, but our modification in surgical technique have lesser and acceptable recurrence rates. The present study aimed to assess the results of modified laparoscopic keyhole plus repair in the treatment of symptomatic PH. Methods We reviewed our prospectively maintained database to search for patients who had undergone laparoscopic modified keyhole repair between January 2008 and April 2018. All 23 symptomatic patients who had undergone this procedure were included in the present study. Results A total of 23 patients were studied. The median age was 37 years (range, 22‐54 years). Two patients with large PHs underwent open excision of the redundant skin and then laparoscopic modified keyhole repair. There was one conversion to open repair because of dense adhesions. The mean operative time was 112 ± 37 minutes. The mean postoperative hospital stay was 3 ± 2 days. There were no significant intraoperative or postoperative complications. During follow‐up, three patients had a seroma, which was managed conservatively. One morbidly obese patient who had an ileal conduit‐related stomal hernia had a symptomatic recurrence 3 years after surgery. Conclusion The modified laparoscopic keyhole plus repair is a safe, feasible, and effective technique for PH repair; it has an acceptable recurrence rate and offers good cosmesis and functional outcomes.