Published online Nov 26, 2018. doi: 10.12998/wjcc.v6.i14.759
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
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.
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.
To assess the safety and feasibility of the modified laparoscopic Sugarbaker repair in patients with PSH.
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.
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.
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.
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.