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Clin Colon Rectal Surg 2014; 27(04): 162-171
DOI: 10.1055/s-0034-1394090
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Parastomal Hernia Repair and Reinforcement: The Role of Biologic and Synthetic Materials

Suzanne Gillern
1   Division of Colon and Rectal Surgery, Department of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania
,
Joshua I. S. Bleier
1   Division of Colon and Rectal Surgery, Department of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania
› Author Affiliations
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Publication History

Publication Date:
10 November 2014 (online)

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Abstract

Parastomal hernia is a prevalent problem and treatment can pose difficulties due to significant rates of recurrence and morbidities of the repair. The current standard of care is to perform parastomal hernia repair with mesh whenever possible. There exist multiple options for mesh reinforcement (biologic and synthetic) as well as surgical techniques, to include type of repair (keyhole and Sugarbaker) and position of mesh placement (onlay, sublay, or intraperitoneal). The sublay and intraperitoneal positions have been shown to be superior with a lower incidence of recurrence. This procedure may be performed open or laparoscopically, both having similar recurrence and morbidity results. Prophylactic mesh placement at the time of stoma formation has been shown to significantly decrease the rates of parastomal hernia formation.

Keywords

parastomal hernia - biologic mesh - synthetic mesh - Sugarbaker technique - keyhole technique