OC-073 THE 3-D FUNNEL MESH TECHNIQUE FOR PARASTOMAL HERNIA REPAIR

Abstract

Abstract Background In previous studies, three-dimensional funnel mesh devices have been used successfully for the repair of PSHs by combining a laparoscopic and ostomy-opening approach Methods We performed an analysis of prospectively collected data of patients who underwent a same-sided stoma reposition with 3D funnel-shaped mesh augmentation in intraperitoneal- onlay position at three departments between the years of 2012 and 2021. 56 patients received an implant with 2.5 cm funnel length and 25 patients with 4cm funnel length. Primary outcome parameters were surgical complications and recurrence rate. Results 81 patients could be included in this analysis. PSH repair was performed in 91% as elective surgery and in 87% in laparoscopic technique. A concomitant incisional hernia (EHS type 2 and 4) was found in 39% and repaired in a single-step procedure with PSH. Major postoperative complications requiring redo surgery were identified in 9.8% (8/81). Overall recurrence rate was 11% (9/81). Only 1 recurrence occurred in the group of 4 cm long implants (1/25= 4%). Median follow-up time was 44 months, and a 1-year follow-up rate of 91.4% was reached. Conclusion PSH repair with 3D funnel mesh in IPOM technique is safe, efficient and easy to perform providing advantageous results compared to other techniques. However the origin mesh funnel (2.5cm length) becomes shortened over time and further shrinkage happens eccentric concerning the flat mesh parts widening the funnel. Changing mesh construction according to consequently use the narrowest funnel (2cm) and it`s lengthening to 4cm led to reduction in recurrence without increasing implant-associated complications