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This version was published on June 1, 2008
Surgical Innovation, Vol. 15, No. 2, 85-89 (2008)
DOI: 10.1177/1553350608319031

Laparoscopic Parastomal Hernia Repair: A Description of the Technique and Initial Results

Emmanouil Zacharakis, MD, PhD

Department of Biosurgery and Surgical Technology, Imperial College London, St Mary's Hospital, London, United Kingdom, e.zacharakis{at}imperial.ac.uk

Roland Hettige, MBBS

Department of Biosurgery and Surgical Technology, Imperial College London, St Mary's Hospital, London, United Kingdom

Sanjay Purkayastha, MRCS

Department of Biosurgery and Surgical Technology, Imperial College London, St Mary's Hospital, London, United Kingdom

Rajesh Aggarwal, MRCS

Department of Biosurgery and Surgical Technology, Imperial College London, St Mary's Hospital, London, United Kingdom

Thanos Athanasiou, MD, PhD, FECTS

Department of Biosurgery and Surgical Technology, Imperial College London, St Mary's Hospital, London, United Kingdom

Ara Darzi, KBE, HonFREng, FMedSci

Department of Biosurgery and Surgical Technology, Imperial College London, St Mary's Hospital, London, United Kingdom

Paul Ziprin, MD, FRCS

Department of Biosurgery and Surgical Technology, Imperial College London, St Mary's Hospital, London, United Kingdom

In this study, the authors review their initial results with the laparoscopic approach for parastomal hernia repair. Between 2006 and 2007, 4 patients were treated laparoscopically at our institution. The hernia sac was not excised. A piece of Gore-Tex DualMesh with a central keyhole and a radial incision was cut so that it could provide at least 3 to 5 cm of overlap of the fascial defect. The mesh was secured to the margins of the hernia with circumferential metal tacking and trans-fascial sutures. No complications occurred in the postoperative period. After a median follow-up of 9 months, recurrence occurred in 1 patient. This was our first patient in whom mesh fixation was performed only with circumferential metal tacking. The laparoscopic repair of parastomal hernias seems to be a safe, feasible and promising technique offering the advantages of minimally-invasive surgery. The success of this approach depends on longer follow-up reports and standardization of the technical elements.

Key Words: parastomal hernia • repair • laparoscopic surgery • mesh • minimal invasive


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