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Updated: Jun 28, 2025
Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
Published on: September 11, 2021
Parastomal hernia repair according to Modified Stapled Mesh Stoma Reinforcement Technique (mSMART): which are the
B Romain1, A Villemin2, S Suciu2
1Department of General and Digestive Surgery, Hautepierre Hospital, Strasbourg University Hospital, 67200, Strasbourg, France. benoit.romain@chru-strasbourg.fr.
Introduction:
Parastomal hernia repair is a real surgical challenge because of the high rate of recurrence. The Stapled Mesh Stoma Reinforcement Technique (SMART) is a keyhole-like technique in which the mesh is stapled to the fascia using a circular mechanical stapler.
Methods:
A prospective study from January 2021 to February 2023 was conducted including all patients operated with the SMART technique. Primary endpoint was the recurrence rate during the follow-up. Secondary endpoints were reoperation, Surgical site Occurrence (SSO) and deep (mesh) surgical site infection (SSI) within 30 days postoperatively.
Results:
Sixteen patients operated on SMART procedures were included. The mean follow-up was 11.3 ± 9.2 months. The SSO rate was 18.7% (n = 3). A seroma was drained radiologically (IIIa), one haematoma was evacuated surgically (IIIb) and one patient presented a postoperative lesion of a ureter after a parastomal Bricker's hernia repair. In addition, there was one death due to multiple organ failure (V). There was no SSI. The recurrence rate was 57.1% during the follow-up.
Conclusion:
This study shows disappointing results for this SMART technique, with a high recurrence rate.
