Parastomal Hernias: Laparoscopic Management

Parastomal hernia is a vexing problem plaguing many patients with permanent ostomies. Laparoscopic parastomal hernia repair with mesh is an attractive option for treatment, offering excellent visualization and potentially fewer wound complications than traditional approaches. However, laparoscopic parastomal hernia repair requires a unique skill set in order to be performed efficiently and safely and is more costly than open surgery. Data are limited regarding recurrence and actual patient benefit, so individual preference drives the use of the minimally invasive technique. This article reviews the available data and focuses on the potential advantages and pitfalls of a laparoscopic approach to parastomal hernia repair. We aim to provide technical insight, while addressing controversies and complications specific to the laparoscopy.