Summary:
Backround Parastomal hernia is one of the most common complications following
stoma creation and its prevalence is only expected to increase. Most parastomal
hernias are asymptomatic and therefore can be treated conservatively. Advances
in operative techniques and technology have facilitated laparoscopic repair of
parastomal hernia. The surgical techniques has evolved over the past two
decades with the introduction of mesh and laparoscopic procedures.
Methods All parastomal hernia repairs were attempted laparoscopically. The
literature was reviewed. Two techniques were compared keyhole technique with
Sugarbaker technique.
Results Between 2004 and 2014, n=515 patients underwent laparoscopic repair of
parastomal hernia with the following techniques keyhole and Sugarbaker. The
complicatios, conversion and recurrence were 6%, 3,7% and 17% respectively and
the mean follow-up range between 8 and 33 months. The mean of median operating
time in 7 studies was 138 minutes with a range between 32 and 326 minutes. As
far as the length of stay in 6 of the studies range between 2 and 20 days.
Conclusion Laparoscopic repair of ventral hernias is increasing in popularity.
This may be attributed to the advantages of such a minimally invasive approach:
small
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incisions, less postoperative pain with fast recovery, and minimal wound
complications. When performing laparoscopic intraperitoneal repair, the choice
can be made between the keyhole and Sugarbaker repair. The recurrence rate is
significantly lower with laparoscopic repair using the Sugarbaker compared to
the keyhole technique. Futhermore Sugarbaker is techniqually less demanding.
Keywords:
Laparoscopic repair, Parastomal hernia, Keyhole, Sugarbaker
