[Prevention of parastomal hernia using laparoscopic introduction of a prosthetic mesh--initial experience].

INTRODUCTION: Parastomal hernia is a very common complication after stoma formation. Current surgical procedures for repairing parastomal hernia have unsatisfactory results. The aim of this study was to evaluate our initial experience with laparoscopic prophylactic mesh placement at the time of stoma formation. MATERIAL AND METHODS: Four patients underwent laparoscopic abdominoperineal rectal cancer resection with prophylactic parastomal mesh placement. A specially designed mesh made of polyvinylidene fluoride with central funnel (Dynamesh IPST) was implanted using an intraperitoneal onlay technique. The surgical data, the frequency of mesh-related complications as well as the rate of parastomal henias were evaluated. RESULTS: The mean operating time for mesh placement was 15 min (10-25 min.). No mesh- related complications or infection was observed and no parastomal hernia could be detected clinically. To this date, the mean follow up time has been six months (4-8 months). CONCLUSION: Laparoscopic prophylactic parastomal mesh placement might be a safe and effective procedure with a potential to reduce the risk of parastomal hernia, at least in the short run. However, our experience is limited due to the small number of patients included in the study. Additional large trials with long term follow up are necessary.