Parastomal Hernia Repair

Procedure Snapshot

• Indication: Symptomatic or complicated parastomal hernia.
• Expected duration: ___
• Special instruments: Mesh (onlay or sugarbaker technique).

Step Workflow

1. Circumferential incision around stoma; dissect to fascial defect.
2. Reduce hernia contents.
3. Close defect primarily or place mesh intraperitoneally (Sugarbaker).
4. Re-mature stoma.

Key Pimp Questions

• Q: Recurrence rate after primary repair? A: Up to 50 % (PMID 30308340).
• Q: Mesh technique advantages? A: Sugarbaker reduces recurrence (PMID 30415660).

Critical Anatomy

• Landmarks: Stoma site, rectus sheath.
• Danger zones: Bowel injury during lysis.

Informed Consent Highlights

• Recurrence __, infection __, seroma ___.

Post-op Considerations

• Binder, bowel function monitoring.

References

• Chassin’s, Hernia chapter. Clinical Scenarios, Abdominal wall.
• Berger 2018 (PMID 30415660).