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Published on: September 11, 2021
Minimally Invasive Pauli Parastomal Hernia Repair
Francesco Guerra1, Giuseppe Giuliani, Lucia Salvischiani
1AUSL Toscana Sud Est, Grosseto- Italy.
Background:
Although originally described as an open procedure, the application in the setting of minimally invasive surgery of the Pauli technique for parastomal hernia repair is gaining interest among surgeons owing to encouraging early results. We aimed at combining and analyzing the results of minimally invasive Pauli repair by assessing the available evidence.
Methods:
A literature search in Pubmed, Embase, and Web of Science was undertaken to include all articles reporting on minimally invasive repair of parastomal hernias using the Pauli technique.
Results:
Data regarding a total of 75 patients across 11 articles published between 2019 and 2023 were included. Patients received surgery either by a laparoscopic (27%) or robotic (73%) approach. A transabdominal route was chosen in 62 patients (83%), while an extraperitoneal technique was employed in the remaining 13 patients. The rate of postoperative morbidity was 34%, with 10% being the incidence of grade >II complications. The reported overall rate of recurrence was 7% at a median follow-up of 1 to 43 months.
Conclusions:
The available evidence derived from a growing number of centers suggests that minimally invasive Pauli repair is a viable option to treat parastomal hernias. Despite robust, high-level data still lacking, preliminary experiences indicate promising results.
Insights
Minimally invasive Pauli repair for parastomal hernias shows promising recurrence rates of 7%. This technique, applied via laparoscopic or robotic surgery, is a viable option despite limited high-level evidence.
Area of Science:
- Surgical Innovation
- Hernia Repair
- Minimally Invasive Surgery
Background:
- The Pauli technique, traditionally open, is increasingly used in minimally invasive surgery for parastomal hernia repair.
- Early encouraging results have spurred interest among surgeons in this approach.
Purpose of the Study:
- To analyze and combine results from minimally invasive Pauli repair for parastomal hernias.
- To assess the available evidence on this surgical technique.
Main Methods:
- A comprehensive literature search was conducted across PubMed, Embase, and Web of Science.
- Included studies reported on minimally invasive parastomal hernia repair using the Pauli technique.
Main Results:
- Data from 75 patients across 11 articles (2019-2023) were analyzed.
- Robotic approaches (73%) were more common than laparoscopic (27%).
- Postoperative morbidity was 34%, with 10% severe complications; recurrence rate was 7%.
Conclusions:
- Minimally invasive Pauli repair is a viable option for treating parastomal hernias.
- Preliminary experiences suggest promising outcomes, though high-level data is still needed.
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