Paracolostomy hernias are one of the most common complications of stomas. Primary repair is associated with a high rate of recurrence. The choice is between mesh-reinforced repair of the defect and relocation of the stoma to another position. The laparoscopic approach seems attractive, as it is minimally invasive, requires shorter hospitalization, and the entry is through a noncontaminated part of the abdomen.
This study consists of a case series of 9 patients with paracolostomy hernia, of which 2 had recurrent hernias. All patients presenting with nonobstructed parastomal hernias at our clinic between October 2006 and October 2009 are included in this series. Two patients that presented with obstruction are not included. We describe our technique for this surgery using the laparoscopic approach and discuss the outcomes.
Nine patients with permanent colostomies in the left lumbar quadrant after abdominoperineal resection presented with parastomal hernias of varying durations and were subjected to laparoscopic repair. The average operating time was 112 minutes. All the patients were mobilized postoperatively and were discharged by 48 hours. None of the patients have reported any complication, including recurrence.
Laparoscopic repair of paracolostomy hernia using a technique involving intracorporeal suturing of defect followed by reinforcement by a tissue-separating mesh is safe and feasible.
SIGMA Surgery, Manjalpur, Baroda, Gujarat, India
Reprints: Kalpesh Jani, MS, DNB, FNB, MNAMS, FICS, FACS, Consultant Surgical Gastroenterologist and Minimal Access Surgeon, SIGMA Surgery, Abhishek House, Opp Tulsidham Appt, Manjalpur, Baroda – 390011, Gujarat India (e-mail: email@example.com).
Disclosure: The video of this procedure was presented at the 94th Annual Clinical Congress of the American College of Surgeons held at San Francisco, USA, on 12th – 16th October, 2008 in the session titled.
Received March 31, 2010
Accepted October 5, 2010