What is a parastomal hernia?
A parastomal hernia is a reversible mass formed when an intra-abdominal organ (intestinal tube or omentum) protrudes within the abdominal wall stoma channel after a patient has undergone abdominal wall stoma surgery. It is one of the common complications after various abdominal wall stoma surgeries.
How many types of parastomal hernias are there?
There are two main types of parastomal hernias, colostomy hernias and ileostomy hernias. The incidence of colostomy hernias is higher, about 4.8%-48.1%, while the incidence of ileostomy hernias is lower, about 1.8%-28.0%.
What are the symptoms of parastomal hernia?
1. Abdominal distension and abdominal pain.
2.Stoma urination and defecation is not smooth.
3. Asymmetric appearance.
4. Repeatable swelling in the stoma area.
5.Poor sealing of the stoma bag, causing local skin irritation symptoms.
In severe cases, the parastomal mass cannot be retracted, accompanied by vomiting and abdominal pain, i.e. it causes intestinal intussusception, which can lead to intestinal obstruction, intestinal necrosis and other conditions, requiring emergency surgery.
How to prevent a parastomal hernia?
Preventive measures include long-term lap band compression bandage (special stoma lap band can be used) after the original surgery. It is also important to avoid actions that increase intra-abdominal pressure such as colds, coughing, sneezing, gas, constipation, and lifting heavy objects. It is also possible to perform a prophylactic repair using a patch directly at the time of the original stoma surgery.
How is a parastomal hernia treated?
Treatment of parastomal hernia includes conservative treatment and surgical treatment.
Conservative treatment consists of a long term lap band with compression bandage.
Surgical treatment includes
1. Open surgery: including open hernia ring suture repair surgery; open stoma displacement surgery; open patch repair surgery.
2. laparoscopic surgery: including total laparoscopic repair of parastomal hernia patch; laparoscopic repair of parastomal hernia patch with stoma redo.
What are the advantages of laparoscopic treatment of parastomal hernia?
Laparoscopic parastomal hernia patch repair combines minimally invasive surgical techniques and the concept of tension-free hernia repair compared to the traditional open repair approach. The surgery does not operate directly on the stoma-contaminated area. It has the advantages of less trauma, faster recovery, lower recurrence rate and lower complication rate.