Abstract
A parastomal hernia is a common complication following stoma surgery. Due to the large number of hernial relapses and other complications, such as infections, adhesion to the intestines, or the formation of adhesions, the treatment of hernias is still a surgical challenge. The current standard for the preventive and causal treatment of parastomal hernias is to perform a procedure with the use of a mesh implant. Researchers are currently focusing on the analysis of many relevant options, including the type of mesh (synthetic, composite, or biological), the available surgical techniques (Sugarbaker’s, “keyhole”, or “sandwich”), the surgical approach used (open or laparoscopic), and the implant position (onlay, sublay, or intraperitoneal onlay mesh). Current surface modification methods and combinations of different materials are actively explored areas for the creation of biocompatible mesh implants with different properties on the visceral and parietal peritoneal side. It has been shown that placing the implant in the sublay and intraperitoneal onlay mesh positions and the use of a specially developed implant with a 3D structure are associated with a lower frequency of recurrences. It has been shown that the prophylactic use of a mesh during stoma formation significantly reduces the incidence of parastomal hernias and is becoming a standard method in medical practice.
Highlights
In addition to the variety of surgical techniques used in the treatment of parastomal hernias, a number of materials are currently available for the replacement of fascia muscular defects in the abdominal wall [24]
The results showed that in the case of sigmoid terminal colostomy, prophylactic mesh placement reduced the incidence of parastomal hernias and associated reoperations
The variety of available mesh implants—their various sizes, materials, possible spatial structures, and related surgical techniques—and the choices of mesh arrangement in relation to the layers of the abdominal wall allow surgeons to choose the best parameters depending on the preferences and needs of the patient
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. The formation of a hernia is the result of intraabdominal pressure that is greater than the strength of the connective tissues [1]. Some diseases promote the development of hernias, including prostate hypertrophy, malnutrition, constipation, diabetes, hypoproteinemia, or previous surgical procedures that weakened the strength of the connective tissue [3]. Post-operative infection and recurrence are the primary problems associated with hernia repair [4]. The formation of peritoneal adhesions between the abdominal viscera and the mesh is another cause for concern and is the most crucial parameter for parastomal hernia repair. The ideal mesh must permit repair of the fascial defect and incorporation into the surrounding body tissue while providing little adhesion, minimal immune reactions, and suitable tensile strength. The aim of this work is to outline the problems related to parastomal hernia, review the key properties of surgical meshes available on the market, present surgical techniques currently used to treat parastomal hernia, and characterize the related complications
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
