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Updated: Jun 27, 2025

Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh

Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh

Published on: September 11, 2021

Parastomal hernia repair, trying to optimize the impossible reconstruction.

S M Maskal¹, R C Ellis², B T Miller²

¹Department of Surgery, Cleveland Clinic, 2049 E 100th St, Cleveland, OH, USA. maskals2@ccf.org.

Hernia : the Journal of Hernias and Abdominal Wall Surgery

|April 28, 2024

Summary

Parastomal hernia repair remains challenging. This study details an optimized approach using preoperative preparation, retrorectus dissection, and the Sugarbaker technique, aiming to reduce complications and recurrence rates.

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Area of Science:

Surgical innovation in abdominal wall reconstruction.
Gastrointestinal surgery and hernia repair.

Background:

Parastomal hernias present significant surgical challenges.
High rates of wound complications and hernia recurrence are common after repair.

Purpose of the Study:

To present an optimized approach for parastomal hernia repair.
Improve surgical outcomes by focusing on preoperative, surgical, and postoperative management.

Main Methods:

Preoperative patient optimization.
Open retromuscular approach with posterior component separation and transversus abdominis release.
Sugarbaker technique for mesh placement, with alternatives for limited bowel length.

Main Results:

Keywords:

Parastomal hernia Retromuscular Keyhole Retromuscular Sugarbaker

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Previous institutional results show up to 16% wound complication rates.

Hernia recurrence rates range from 11-30% within 2 years.

Stoma-specific complications like mesh erosion are a concern.

Conclusions:

An open retromuscular approach with Sugarbaker mesh is preferred for complex parastomal hernias.
Wound morbidity and repair failure rates remain high.
Further research is necessary to optimize surgical outcomes.