Laparoscopic parastomal hernia repair using a nonslit mesh technique

Gregory Mancini, D. A. McClusky, L. Khaitan, E. A. Goldenberg, B. T. Heniford, Y. W. Novitsky, A. E. Park, S. Kavic, K. A. LeBlanc, M. J. Elieson, G. R. Voeller, Bruce Ramshaw

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Background: The management of parastomal hernia is associated with high morbidity and recurrence rates (20-70%). This study investigated a novel laparoscopic approach and evaluated its outcomes. Methods: A consecutive multi-institutional series of patients undergoing parastomal hernia repair between 2001 and 2005 were analyzed retrospectively. Laparoscopy was used with modification of the open Sugarbaker technique. A nonslit expanded polytetrafluoroethylene (ePTFE) mesh was placed to provide 5-cm overlay coverage of the stoma and defect. Transfascial sutures secured the mesh, allowing the stoma to exit from the lateral edge. Five advanced laparoscopic surgeons performed all the procedures. The primary outcome measure was hernia recurrence. Results: A total of 25 patients with a mean age of 60 years and a body mass index of 29 kg/m2 underwent surgery. Six of these patients had undergone previous mesh stoma revisions. The mean size of the hernia defect was 64 cm2, and the mean size of the mesh was 365 cm2. There were no conversions to open surgery. The overall postoperative morbidity was 23%, and the mean hospital length of stay was 3.3 days. One patient died of pulmonary complications; one patient had a trocar-site infection; and one patient had a mesh infection requiring mesh removal. During a median follow-up period of 19 months (range, 2-38 months), 4% (1/25) of the patients experienced recurrence. Conclusion: On the basis of this large case series, the laparoscopic nonslit mesh technique for the repair of parastomal hernias seems to be a promising approach for the reduction of hernia recurrence in experienced hands.

Original languageEnglish (US)
Pages (from-to)1487-1491
Number of pages5
JournalSurgical Endoscopy and Other Interventional Techniques
Volume21
Issue number9
DOIs
StatePublished - Sep 1 2007
Externally publishedYes

Fingerprint

Herniorrhaphy
Hernia
Recurrence
Length of Stay
Conversion to Open Surgery
Morbidity
Polytetrafluoroethylene
Infection
Surgical Instruments
Laparoscopy
Sutures
Body Mass Index
Outcome Assessment (Health Care)
Lung

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Laparoscopic parastomal hernia repair using a nonslit mesh technique. / Mancini, Gregory; McClusky, D. A.; Khaitan, L.; Goldenberg, E. A.; Heniford, B. T.; Novitsky, Y. W.; Park, A. E.; Kavic, S.; LeBlanc, K. A.; Elieson, M. J.; Voeller, G. R.; Ramshaw, Bruce.

In: Surgical Endoscopy and Other Interventional Techniques, Vol. 21, No. 9, 01.09.2007, p. 1487-1491.

Research output: Contribution to journalArticle

Mancini, G, McClusky, DA, Khaitan, L, Goldenberg, EA, Heniford, BT, Novitsky, YW, Park, AE, Kavic, S, LeBlanc, KA, Elieson, MJ, Voeller, GR & Ramshaw, B 2007, 'Laparoscopic parastomal hernia repair using a nonslit mesh technique', Surgical Endoscopy and Other Interventional Techniques, vol. 21, no. 9, pp. 1487-1491. https://doi.org/10.1007/s00464-007-9419-1
Mancini, Gregory ; McClusky, D. A. ; Khaitan, L. ; Goldenberg, E. A. ; Heniford, B. T. ; Novitsky, Y. W. ; Park, A. E. ; Kavic, S. ; LeBlanc, K. A. ; Elieson, M. J. ; Voeller, G. R. ; Ramshaw, Bruce. / Laparoscopic parastomal hernia repair using a nonslit mesh technique. In: Surgical Endoscopy and Other Interventional Techniques. 2007 ; Vol. 21, No. 9. pp. 1487-1491.
@article{712f1853c5f247ed8b0cbfea3b34d01e,
title = "Laparoscopic parastomal hernia repair using a nonslit mesh technique",
abstract = "Background: The management of parastomal hernia is associated with high morbidity and recurrence rates (20-70{\%}). This study investigated a novel laparoscopic approach and evaluated its outcomes. Methods: A consecutive multi-institutional series of patients undergoing parastomal hernia repair between 2001 and 2005 were analyzed retrospectively. Laparoscopy was used with modification of the open Sugarbaker technique. A nonslit expanded polytetrafluoroethylene (ePTFE) mesh was placed to provide 5-cm overlay coverage of the stoma and defect. Transfascial sutures secured the mesh, allowing the stoma to exit from the lateral edge. Five advanced laparoscopic surgeons performed all the procedures. The primary outcome measure was hernia recurrence. Results: A total of 25 patients with a mean age of 60 years and a body mass index of 29 kg/m2 underwent surgery. Six of these patients had undergone previous mesh stoma revisions. The mean size of the hernia defect was 64 cm2, and the mean size of the mesh was 365 cm2. There were no conversions to open surgery. The overall postoperative morbidity was 23{\%}, and the mean hospital length of stay was 3.3 days. One patient died of pulmonary complications; one patient had a trocar-site infection; and one patient had a mesh infection requiring mesh removal. During a median follow-up period of 19 months (range, 2-38 months), 4{\%} (1/25) of the patients experienced recurrence. Conclusion: On the basis of this large case series, the laparoscopic nonslit mesh technique for the repair of parastomal hernias seems to be a promising approach for the reduction of hernia recurrence in experienced hands.",
author = "Gregory Mancini and McClusky, {D. A.} and L. Khaitan and Goldenberg, {E. A.} and Heniford, {B. T.} and Novitsky, {Y. W.} and Park, {A. E.} and S. Kavic and LeBlanc, {K. A.} and Elieson, {M. J.} and Voeller, {G. R.} and Bruce Ramshaw",
year = "2007",
month = "9",
day = "1",
doi = "10.1007/s00464-007-9419-1",
language = "English (US)",
volume = "21",
pages = "1487--1491",
journal = "Surgical Endoscopy",
issn = "0930-2794",
publisher = "Springer New York",
number = "9",

}

TY - JOUR

T1 - Laparoscopic parastomal hernia repair using a nonslit mesh technique

AU - Mancini, Gregory

AU - McClusky, D. A.

AU - Khaitan, L.

AU - Goldenberg, E. A.

AU - Heniford, B. T.

AU - Novitsky, Y. W.

AU - Park, A. E.

AU - Kavic, S.

AU - LeBlanc, K. A.

AU - Elieson, M. J.

AU - Voeller, G. R.

AU - Ramshaw, Bruce

PY - 2007/9/1

Y1 - 2007/9/1

N2 - Background: The management of parastomal hernia is associated with high morbidity and recurrence rates (20-70%). This study investigated a novel laparoscopic approach and evaluated its outcomes. Methods: A consecutive multi-institutional series of patients undergoing parastomal hernia repair between 2001 and 2005 were analyzed retrospectively. Laparoscopy was used with modification of the open Sugarbaker technique. A nonslit expanded polytetrafluoroethylene (ePTFE) mesh was placed to provide 5-cm overlay coverage of the stoma and defect. Transfascial sutures secured the mesh, allowing the stoma to exit from the lateral edge. Five advanced laparoscopic surgeons performed all the procedures. The primary outcome measure was hernia recurrence. Results: A total of 25 patients with a mean age of 60 years and a body mass index of 29 kg/m2 underwent surgery. Six of these patients had undergone previous mesh stoma revisions. The mean size of the hernia defect was 64 cm2, and the mean size of the mesh was 365 cm2. There were no conversions to open surgery. The overall postoperative morbidity was 23%, and the mean hospital length of stay was 3.3 days. One patient died of pulmonary complications; one patient had a trocar-site infection; and one patient had a mesh infection requiring mesh removal. During a median follow-up period of 19 months (range, 2-38 months), 4% (1/25) of the patients experienced recurrence. Conclusion: On the basis of this large case series, the laparoscopic nonslit mesh technique for the repair of parastomal hernias seems to be a promising approach for the reduction of hernia recurrence in experienced hands.

AB - Background: The management of parastomal hernia is associated with high morbidity and recurrence rates (20-70%). This study investigated a novel laparoscopic approach and evaluated its outcomes. Methods: A consecutive multi-institutional series of patients undergoing parastomal hernia repair between 2001 and 2005 were analyzed retrospectively. Laparoscopy was used with modification of the open Sugarbaker technique. A nonslit expanded polytetrafluoroethylene (ePTFE) mesh was placed to provide 5-cm overlay coverage of the stoma and defect. Transfascial sutures secured the mesh, allowing the stoma to exit from the lateral edge. Five advanced laparoscopic surgeons performed all the procedures. The primary outcome measure was hernia recurrence. Results: A total of 25 patients with a mean age of 60 years and a body mass index of 29 kg/m2 underwent surgery. Six of these patients had undergone previous mesh stoma revisions. The mean size of the hernia defect was 64 cm2, and the mean size of the mesh was 365 cm2. There were no conversions to open surgery. The overall postoperative morbidity was 23%, and the mean hospital length of stay was 3.3 days. One patient died of pulmonary complications; one patient had a trocar-site infection; and one patient had a mesh infection requiring mesh removal. During a median follow-up period of 19 months (range, 2-38 months), 4% (1/25) of the patients experienced recurrence. Conclusion: On the basis of this large case series, the laparoscopic nonslit mesh technique for the repair of parastomal hernias seems to be a promising approach for the reduction of hernia recurrence in experienced hands.

UR - http://www.scopus.com/inward/record.url?scp=34548457707&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34548457707&partnerID=8YFLogxK

U2 - 10.1007/s00464-007-9419-1

DO - 10.1007/s00464-007-9419-1

M3 - Article

VL - 21

SP - 1487

EP - 1491

JO - Surgical Endoscopy

JF - Surgical Endoscopy

SN - 0930-2794

IS - 9

ER -