Hernia

, Volume 20, Issue 1, pp 151–159 | Cite as

Prevention of parastomal hernias with 3D funnel meshes in intraperitoneal onlay position by placement during initial stoma formation

  • G. Köhler
  • A. Hofmann
  • M. Lechner
  • F. Mayer
  • H. Wundsam
  • K. Emmanuel
  • R. H. Fortelny
Original Article

Abstract

Purpose

In patients with terminal ostomies, parastomal hernias (PSHs) occur on a frequent basis. They are commonly associated with various degrees of complaints and occasionally lead to life-threatening complications. Various strategies and measures have been tested and evaluated, but to date there is a lack of published evidence with regard to the best surgical technique for the prevention of PSH development.

Methods

We conducted a retrospective analysis of prospectively collected data of eighty patients, who underwent elective permanent ostomy formation between 2009 and 2014 by means of prophylactic implantation of a three-dimensional (3D) funnel mesh in intraperitoneal onlay (IPOM) position.

Results

PSH developed in three patients (3.75 %). No mesh-related complications were encountered and none of the implants had to be removed. Ostomy-related complications had to be noted in seven (8.75 %) cases. No manifestation of ostomy prolapse occurred. Follow-up time was a median 21 (range 3–47) months.

Conclusion

The prophylactical implantation of a specially shaped, 3D mesh implant in IPOM technique during initial formation of a terminal enterostomy is safe, highly efficient and comparatively easy to perform. As opposed to what can be achieved with flat or keyhole meshes, the inner boundary areas of the ostomy itself can be well covered and protected from the surging viscera with the 3D implants. At the same time, the vertical, tunnel-shaped part of the mesh provides sufficient protection from an ostomy prolapse. Further studies will be needed to compare the efficacy of various known approaches to PSH prevention.

Keywords

Parastomal hernia Prevention Three-dimensional funnel mesh Intraperitoneal onlay mesh 

Notes

Acknowledgments

The authors thank our hospitals’ stoma care nurses Martina Signer (Steinbeiß), Adelheid Anzinger, and Christa Sorg for their highly valuated support and long-standing empathic care in the management of all our patients with ostomies and stoma-related problems.

Conflict of interest

G. K. declares no conflict of interest. A. H. declares no conflict of interest. M. L. declares no conflict of interest. F. M. declares no conflict of interest. H. W. declares no conflict of interest. K. E. declares no conflict of interest. R. H. F. declares no conflict of interest.

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Copyright information

© Springer-Verlag France 2015

Authors and Affiliations

  • G. Köhler
    • 1
    • 2
    • 3
    • 5
  • A. Hofmann
    • 4
  • M. Lechner
    • 5
  • F. Mayer
    • 5
  • H. Wundsam
    • 1
    • 2
    • 3
  • K. Emmanuel
    • 1
    • 2
    • 3
  • R. H. Fortelny
    • 4
    • 5
  1. 1.Department of General and Visceral SurgerySisters of Charity HospitalLinzAustria
  2. 2.Academic Teaching Hospital of the University of GrazGrazAustria
  3. 3.Academic Teaching Hospital of the University of InnsbruckInnsbruckAustria
  4. 4.Department of General, Visceral and Oncological SurgeryWilhelminenspitalViennaAustria
  5. 5.Department of SurgeryParacelsus Medical UniversitySalzburgAustria

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