Laparoscopic Parastomal Hernia Repair

Abstract

AbstractParastomal hernia is an incisional hernia resulting from an abdominal wall stoma creation [1]. The published incidence of parastomal hernia varies widely, with 2–28% and 4–48% affecting end ileostomies and end colostomies, respectively, depending on the severity of the hernia, method of diagnosis, and the duration of follow-up [2]. Loop stomas have a much lower incidence of parastomal herniation, as these tend to be reversed before a hernia can develop. The risk of herniation is cumulative with time but appears to be highest within 2 years of ostomy formation. Most patients are asymptomatic or have mild complaints such as intermittent discomfort or sporadic obstructive symptoms, but many eventually have symptoms significant enough to warrant surgical intervention, including incarceration, strangulation, and perforation. The bulging around the stoma can also cause result in difficulty applying the stoma appliance, resulting in leakage and skin irritation [2].