Retrospective Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2018; 6(14): 759-766
Published online Nov 26, 2018. doi: 10.12998/wjcc.v6.i14.759
Modified laparoscopic Sugarbaker repair of parastomal hernia with a three-point anchoring technique
Di-Yu Huang, Long Pan, Qi-Long Chen, Xiao-Yan Cai, Jie Fang
Di-Yu Huang, Long Pan, Institute of Minimally Invasive Surgery, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
Di-Yu Huang, Long Pan, Clinical Medicine Research Center for Minimally Invasive Diagnosis and Treatment of Abdominal Viscera of Zhejiang Province, Hangzhou 310016, Zhejiang Province, China
Di-Yu Huang, Long Pan, Qi-Long Chen, Xiao-Yan Cai, Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
Jie Fang, Department of General Medicine, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
Author contributions: Huang DY and Pan L contributed equally to this work; Huang DY, Pan L, and Fang J designed and performed the research; Chen QL and Cai XY collected and analyzed the data; Huang DY and Pan L wrote the paper; Fang J revised the paper.
Institutional review board statement: This study was reviewed and approved by the ethics committee of Sir Run Run Shaw Hospital.
Informed consent statement: The patients were not required to provide informed consent for this study because the study is retrospective and anonymous clinical data were collected after the patients had agreed to treatment via the laparoscopic technique and signed written surgical informed consent. The surgical informed consent has been uploaded with the manuscript.
Conflict-of-interest statement: All the authors declare no conflicts of interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jie Fang, MD, Attending Doctor, Department of General Medicine, Sir Run Run Shaw Hospital, Zhejiang University, 3 East Qingchun Road, Jianggan District, Hangzhou 310016, Zhejiang Province, China. 3415317@zju.edu.cn
Telephone: +86-571-86006617 Fax: +86-571-86044817
Received: August 8, 2018
Peer-review started: August 8, 2018
First decision: August 24, 2018
Revised: September 13, 2018
Accepted: October 11, 2018
Article in press: October 12, 2018
Published online: November 26, 2018
Processing time: 110 Days and 21.3 Hours
ARTICLE HIGHLIGHTS
Research background

Parastomal hernia (PSH) is a common complication following enterostomy. The laparoscopic Sugarbaker technique has been shown to be the most effective method and is recommended by the International Endohernia Society. However, no consensus exists regarding the mesh selection procedure, the method of mesh fixation, and other operative technical details for this technique.

Research motivation

One of the technical details most difficult to determine during the laparoscopic Sugarbaker technique is a strategy for reliably fixing the mesh to construct a safe funnel. We applied a modified Sugarbaker technique to PSH in our center to try to reduce the technical difficulty.

Research objectives

To assess the safety and feasibility of the modified laparoscopic Sugarbaker repair in patients with PSH.

Research methods

A total of 8 patients received modified laparoscopic Sugarbaker hernia repair treatment. This modified technique included an innovative three-point anchoring and complete suturing technique to fix the mesh. Perioperative outcomes, including operative and postoperative complications, were collected to retrospectively evaluate the safety and efficacy of this modified technique.

Research results

All the hernias were repaired using the modified laparoscopic Sugarbaker technique with no conversion to laparotomy. The mean operative time was 205.6 min, and the mean postoperative hospitalization time was 10.4 d, with a median pain score of 1 (visual analog scale method) at postoperative day 1. Two patients experienced mild postoperative complications and recovered after conservative management. No recurrence occurred during the follow-up period.

Research conclusions

The modified laparoscopic Sugarbaker repair with three-point anchoring technique could fix the mesh reliably with mild postoperative pain and a low recurrence rate. The technique is safe and feasible for PSH.

Research perspectives

Our study demonstrates that the modified laparoscopic Sugarbaker repair is safe and efficient via three-point anchoring for PSH. Surgeons can use our method to repair PSH.