Parastomal hernia mesh repair, variant of surgical technique without stoma relocation

Due to the improvement of prognosis through adjuvant therapy, the life expectancy of neoplasia patients is continuously increasing, which, in conjunction with the progressive occurrence of parastomal hernias during the disease evolution, explains the growing number of reported parastomal hernias affecting patients with permanent colostomy. Conventional techniques of local repair are inappropriate considering the high recurrence rate, and the decision of stoma relocation depends on the associated pathology, which may counter-indicate general anesthesia, and on previous surgical interventions that are usually followed by a dense peritoneal adhesion syndrome.

The purpose of this article is to make known a variant of alloplastic technique, without translocation, with a low degree of invasiveness, which can be performed successfully under spinal anesthesia, followed by a reduced period of hospitalization.

The study group consisted of 6 patients with permanent left iliac anus who underwent these interventions one to three years prior to the occurrence of parastomal hernia. Patients were followed at 1 year and 2 years postoperatively and the results were favorable, with no recurrence and improved quality of life through proper prosthesis of the stoma.

We suggest that this technique variation is applied to small and medium parastomal hernias, in case of patients with permanent left iliac anus, with the declared intent of minimal invasiveness.