J Korean Surg Soc.  2013 Jun;84(6):371-376. 10.4174/jkss.2013.84.6.371.

Laparoscopic repair of parastomal and incisional hernias with a modified Sugarbaker technique

• Jeong DH
• Park MG
• Melich G
• Hur H
• Min BS
• Baik SH
• Kim NK

• KMID: 1505188
• DOI: http://doi.org/10.4174/jkss.2013.84.6.371

Abstract

A parastomal hernia is the most common surgical complication following stoma formation. As the field of laparoscopic surgery advances, different laparoscopic approaches to repair of parastomal hernias have been developed. Recently, the Sugarbaker technique has been reported to have lower recurrence rates compared to keyhole techniques. As far as we know, the Sugarbaker technique has not yet been performed in Korea. We herein present a case report of perhaps the first laparoscopic parastomal hernia repair with a modified Sugarbaker technique to be successfully carried out in Korea. A 79-year-old woman, who underwent an abdominoperineal resection for an adenocarcinoma of the rectum 9 years ago, presented with a large parastomal and incisional hernias, and was treated with a laparoscopic repair with a modified Sugarbaker technique. Six months after surgery, follow-up with the patient has shown no evidence of recurrence.

Keyword

Laparoscopy; Abdominal hernia; Surgical stomas; Surgical procedures; Minimally invasive

MeSH Terms

Adenocarcinoma
Female
Follow-Up Studies
Hernia
Hernia, Abdominal
Herniorrhaphy
Humans
Korea
Laparoscopy
Rectum
Recurrence
Surgical Stomas

Figure

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  Fig. 1 Large parastomal (A) and incisional hernias (B). The patient visited the emergency room with severe abdominal pain and vomiting.

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  Fig. 2 Abdominopelvic computed tomography showed a large parastomal hernia (A) with concomitant incisional hernias (B) and a loss of fascia around the ostomy site with herniation of small bowel and greater omentum.

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  Fig. 3 Positioning of trocars, operator and equipment for the laparoscopic repair of a parastomal hernia of a left sided colostomy with supraumbilical incisional hernia.

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  Fig. 4 Laparoscopic views of operation procedures. (A) The incisional hernia sac. (B) Incisional hernia was closed using an Endo Closure device. (C) Composite mesh was applied with Sugarbaker technique. (D) The margin of the mesh was fixed with a mechanical fixation device (autosuture endoscopic tacker).

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  Fig. 5 Appearance of the abdomen after surgery.

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  Fig. 6 Outpatient clinic after surgery.

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