Skip to main content

Advertisement

SpringerLink
Log in

The modified laparoscopic keyhole parastomal hernia repair with in situ re-ostomy has low recurrence rate

  • How-I-Do-It
  • Published:
Hernia Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to present a modified laparoscopic keyhole parastomal hernia repair technique with in situ re-ostomy and show its safety and feasibility at a mid-term follow-up.

Methods

The technique begins with adhesiolysis during laparoscopy. An annular incision is made between the skin and stomal mucosa. Then, after all adhesions of the stomal bowel and its mesentery are separated from the hernial sac, the stomal bowel is delivered through the keyhole mesh. The mesh is then stitched to the stomal bowel and placed intraperitoneally. The hernial ring is narrowed, and the mesh is further stitched to the hernial ring and stomal tube. After the mesh is fixed, the redundant stomal bowel is shortened, and a new in situ stoma is matured in the conventional way.

Results

Altogether, 65 consecutive patients underwent successful hernia repair via a modified laparoscopic keyhole with in situ re-ostomy. Two of the patients had recurrent parastomal hernias. No mortalities occurred during the perioperative period. Morbidities included two cases of seroma and three of ileus, all of which were cured with conservative treatment. In addition, one case of intestinal perforation was rescued by intestinal resection and enteroenterostomy. Median follow-up was 29 months (range 3–60 months). No complications of mesh-related infection or patch erosion were noted during the follow-up.

Conclusions

Modified laparoscopic keyhole parastomal hernia repair with in situ re-ostomy is a safe procedure with a low recurrence rate at the mid-term follow-up.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

References

  1. Hiranyakas A, Ho YH (2010) Laparoscopic parastomal hernia repair. Dis Colon Rectum 9:1334–1336

    Article  Google Scholar 

  2. Carne PW, Robertson GM, Frizelle FA (2003) Parastomal hernia. Br J Surg 90:784–793

    Article  PubMed  CAS  Google Scholar 

  3. Cingi A, Cakir T, Sever A, Aktan AO (2006) Enterostomy site hernias: a clinical and computerized tomographic evaluation. Dis Colon Rectum 49:1559–1563

    Article  PubMed  Google Scholar 

  4. Hansson BM, Slater NJ, As VDV, Groenewoud HM, Buyne OR, de Hingh IH, Bleichrodt RP (2012) Surgical techniques for parastomal hernia repair: a systematic review of the literature. Ann Surg 255:685–695

    Article  PubMed  Google Scholar 

  5. Hotouras A, Murphy J, Thaha M, Chan CL (2013) The persistent challenge of parastomal herniation: a review of the literature and future developments. Colorectal Dis 15:202–214

    Article  Google Scholar 

  6. Hansson BM, Bleichrodt RP, de Hingh IH (2009) Laparoscopic parastomal hernia repair using a keyhole technique results in a high recurrence rate. Surg Endosc 23:1456–1459

    Article  PubMed  CAS  Google Scholar 

  7. Muysoms EE, Hauters PJ, Van NY, Huten N, Claeys DA (2008) Laparoscopic repair of parastomal hernias: a multi-centre retrospective review and shift in technique. Acta Chir Belg 108:400–404

    Article  PubMed  CAS  Google Scholar 

  8. Safadi B (2004) Laparoscopic repair of parastomal hernias: early results. Surg Endosc 18:676–680

    Article  PubMed  CAS  Google Scholar 

  9. López-Cano M, Serra-Aracil X, Mora L, Sánchez-García JL, Jiménez-Gómez LM, Martí M, Vallribera F, Fraccalvieri D, Serracant A, Kreisler E (2016) Preventing parastomal hernia using a modified sugarbaker technique with composite mesh during laparoscopic abdominoperineal resection: a randomized controlled trial. Ann Surg 264:923–928

    Article  PubMed  Google Scholar 

  10. Cornille JB, Pathak S, Daniels IR, Smart NJ (2017) Prophylactic mesh use during primary stoma formation to prevent parastomal hernia. Ann R Coll Surg Engl 99:2–11

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  11. Rosch R, Junge K, Böhm G, Conze J, Schumpelick V (2008) Surgical treatment and prophylaxis of parastomal hernias. Zentralblatt Für Chirurgie 133:464–467

    Article  PubMed  CAS  Google Scholar 

  12. Junge K, Klinge U, Rosch R, Mertens PR, Kirch J, Klosterhalfen B, Lynen P, Schumpelick V (2004) Decreased collagen type I/III ratio in patients with recurring hernia after implantation of alloplastic prostheses. Langenbecks Arch Surg 389:17–22

    Article  PubMed  Google Scholar 

  13. Rosch R, Junge K, Knops M, Lynen P, Klinge U, Schumpelick V (2003) Analysis of collagen-interacting proteins in patients with incisional hernias. Langenbecks Arch Surg 387:427–432

    PubMed  CAS  Google Scholar 

  14. Berger D, Bientzle M (2007) Laparoscopic repair of parastomal hernias: a single surgeon’s experience in 66 patients. Dis Colon Rectum 50:1668–1673

    Article  PubMed  Google Scholar 

  15. Chapman SJ, Drake TM, Young N, Jayne DG (2017) Systematic review and meta-analysis of prophylactic mesh during primary stoma formation to prevent parastomal hernia. Dis Colon Rectum 60:107–115

    Article  PubMed  Google Scholar 

  16. Israelsson LA (2005) Preventing and treating parastomal hernia. World J Surg 29:1086–1089

    Article  PubMed  Google Scholar 

  17. Hogg ME, King PM, Keenan RA (2009) A modified lateral approach to parastomal hernia repair. Surgeon 7:56–58

    Article  PubMed  CAS  Google Scholar 

  18. Yang X, He K, Rong H, Shen Q, Yao Q (2017) Laparoscopic repair of parastomal hernia. Ann Transl Med 5:45

    Article  PubMed  PubMed Central  CAS  Google Scholar 

Download references

Acknowledgements

This work was supported by the National Natural Science Foundation of China (no. 81600059/81370496) and Natural Science Foundation of Shandong Province Grants (ZR2014HQ004). We thank Nancy Schatken BS, MT(ASCP), from Liwen Bianji, Edanz Group China (http://www.liwenbianji.cn/ac), for editing the English text of a draft of this manuscript.

Author information

Authors and Affiliations

  1. Department of General Surgery, Qilu Hospital of Shandong University, 107 Wenhuaxi Rd., Jinan, 250012, Shandong, People’s Republic of China

    Zhibo Yan, Hanxiang Zhan, Dong Wu, Yugang Cheng, Qunzheng Wu & Guangyong Zhang

  2. Department of General Surgery, Linyi People’s Hospital, Linyi, 276000, Shandong, People’s Republic of China

    Haifeng Zhang

Authors
  1. Zhibo Yan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Haifeng Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hanxiang Zhan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Dong Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yugang Cheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Qunzheng Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Guangyong Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conception: Guangyong Zhang, Haifeng Zhang; Acquisition of data: Zhibo Yan, Haifeng Zhang, Hanxiang Zhan, Dong Wu, Yugang Cheng, Qunzheng Wu; Analysis of data: all authors; Writing: Zhibo Yan, Guangyong Zhang; Critical revision: all authors; Final approval: all authors.

Corresponding author

Correspondence to Guangyong Zhang.

Ethics declarations

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee, and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Statement of human and animal rights

This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yan, Z., Zhang, H., Zhan, H. et al. The modified laparoscopic keyhole parastomal hernia repair with in situ re-ostomy has low recurrence rate. Hernia 22, 685–690 (2018). https://doi.org/10.1007/s10029-018-1789-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-018-1789-x

Keywords

Search

Navigation