A novel technique for preventing parastomal hernia: laparoscopic extraperitoneal route to colostomy combined with retromuscular prophylactic mesh.

Abstract

Parastomal hernia (PSH) is a common complication following stoma formation. Although prophylactic mesh placement initially showed that promise, recent long-term follow-up randomized trials have demonstrated its ineffectiveness. To enhance PSH prevention, modifications in technique are necessary. We introduced a novel laparoscopic method, the laparoscopic extraperitoneal route to colostomy combined with retromuscular prophylactic mesh. This study documents detailed surgical procedures and postoperative outcomes. Up to now, after a median follow-up of 13 (range: 12-16) months, none of the five subjects in our study cohort experienced a PSH or other serious complication. Impressively, all these patients were followed up for over 1 year. In conclusion, the laparoscopic extraperitoneal route to colostomy combined with retromuscular prophylactic mesh appears to be safe and feasible for patients who need permanent sigmoidostomy. The procedure provides a novel option for those patients.