GORE BIO-A mesh in parastomal hernia prevention: IDEAL Stage 2a with case series

Parastomal hernia (PSH) is a common complication of stoma formation, with an incidence of up to 80%. PSH carries significant morbidity associated with pain and physical function, emphasizing the importance of its prevention. The aim of this work is to review those patients who underwent prophylactic placement of GORE® BIO-A® (Delaware, USA) mesh in accordance with IDEAL Stage 2a and its effectiveness in preventing PSH.

A retrospective case series study was performed at Royal Prince Alfred Hospital, a quaternary centre in Sydney, Australia. Twenty-four patients who underwent prophylactic placement of GORE® BIO-A® mesh at the time of stoma formation by a single surgeon between 2014 and 2022 were included. The presence of PSH on their most current imaging on CT was assessed by a Fellow of the Royal Australasian and New Zealand College of Radiologists.

Out of 24 patients, four (16.7%) had radiological evidence of PSH identified on their progress CT scan. The mean age of all patients was 63 years and all patients had permanent end colostomies. The mean duration between the operation and latest CT scan was 30 months.

The use of GORE® BIO-A® at the time of stoma formation may reduce the rate of PSH. The significantly low incidence of PSH identified in this study indicates that GORE BIO-A mesh has the potential to reduce the risk of PSH formation and its complications. The current IDEAL Stage 2a provides the opportunity for further research with this novel mesh and the technique of prevention of PSH.