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Published on: September 11, 2021
Robotic parastomal hernia repair with reinforced tissue matrix; lessons learned from our 74-patient cohort
J E Baart1, T C van Smaalen1, A L A Bloemendaal1
1Department of Surgery, Reinier de Graaf Gasthuis, Delft, Netherlands.
Introduction:
Patients with a stoma often develop a parastomal hernia (PSH). Treatment of PSH is challenging and results are often disappointing, with many patients developing multiple recurrences. In this study we aim to describe our experiences with the treatment of PSH using our robot assisted operative technique, by exploring patient history and PSH repair outcome and giving in-depth description of failures and successes. We try to identify and better understand predicting factors for failure, postoperative complications and recurrence in an attempt to make a small step towards a more patient-tailored approach to parastomal hernia repair.
Methods:
All (robotic) PSH repairs performed in our centre from March 2022 to January 2026 were registered in a prospectively collected database.
Results:
In this period 74 patients underwent a robotic PSH repair. Almost half of these patients (46%) had undergone one or more previous attempts to PSH repair. Nine recurrences occurred (12%). Complication rate was 31% (9.5% severe complications). IPOM mesh in situ, ileostomy and amount of previous repair attempts may be related to recurrence and post-operative complications.
Conclusion:
This study highlights the complexity for PSH repair, becoming increasingly more complex in recurrent cases. More (comparative) research is needed to establish a more patient-tailored approach to PSH repair.
