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Parastomal hernia repair with a 3-D mesh device and additional flat mesh repair of the abdominal wall

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Abstract

Purpose

Parastomal hernias (PSHs) have been a major clinical problem. The aim of this study was to evaluate a new method of PSH repair in combination with an additional flat mesh reinforcement of the abdominal wall.

Methods

In a pilot case series, seven patients suffering from complex PSHs (≥5 cm diameter and/or recurrence) underwent surgery and were treated by intraperitoneal onlay technique (IPOM) with a synthetic 3-D funnel-shaped mesh implant. The demographics, perioperative, and follow-up data are presented in this report.

Results

The surgical strategy varied between purely laparoscopic (n = 1), laparoscopically assisted (hybrid n = 3), or open techniques (n = 3) using original or suture-reconstructed mesh devices. The funnel mesh implantations in IPOM technique were combined with attached flat meshes in the appropriate position of the abdominal wall. No procedure-related complications occurred. The mean length of hospital stay was 12 days and the mean operating time was 171 min. No recurrence of PSH or incisional hernias was observed during a mean follow-up period of 12.3 months (range from 7 to 22).

Conclusion

The use of a 3-D mesh implant has so far shown to be a promising option in the treatment of primary and recurrent PSHs. Its use proved to be reasonable in both laparoscopic and open IPOM technique. PSHs were preferably repaired using the original, unmodified implant, but when we also found it safe to incise, place and then suture the mesh around the pre-existing ostomy.

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Conflict of interest

GK declares no conflict of interest. OK declares no conflict of interest. SA declares no conflict of interest. ML declares no conflict of interest. FM declares no conflict of interest. UK declares conflict of interest not directly to the submitted work (consulting and/or speaking fees and expert testimony in the field of mesh surgery from FEG Aachen, Life Cell Corp.,CR Bard Inc., Ethicon). KE declares no conflict of interest.

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Authors and Affiliations

  1. Department of General and Visceral Surgery, Sisters of Charity Hospital, 4010, Linz, Austria

    G. Köhler, O. O. Koch & K. Emmanuel

  2. Academic Teaching Hospital of the Universities of Graz, Graz, Austria

    G. Köhler, O. O. Koch & K. Emmanuel

  3. Academic Teaching Hospital of the Universities of Innsbruck, Innsbruck, Austria

    G. Köhler, O. O. Koch & K. Emmanuel

  4. Center for Minimally Invasive Surgery, Hospital Neuwerk, Moenchengladbach, Germany

    S. A. Antoniou

  5. Department of Surgery, Paracelsus Medical University, Salzburg, Austria

    M. Lechner & F. Mayer

  6. Department of General, Visceral and Transplantation Surgery, RWTH Aachen University, Aachen, Germany

    U. Klinge

Authors
  1. G. Köhler
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  2. O. O. Koch
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  3. S. A. Antoniou
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  4. M. Lechner
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  5. F. Mayer
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  6. U. Klinge
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  7. K. Emmanuel
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Corresponding author

Correspondence to G. Köhler.

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Köhler, G., Koch, O.O., Antoniou, S.A. et al. Parastomal hernia repair with a 3-D mesh device and additional flat mesh repair of the abdominal wall. Hernia 18, 653–661 (2014). https://doi.org/10.1007/s10029-014-1302-0

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  • DOI: https://doi.org/10.1007/s10029-014-1302-0

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