The Use of Prosthetic Materials As a Prevention of Incisional Hernias After Stoma Take Down

Morris E Franklin, JR, MD FACS, Karla Russek, MD, Jojy George, MD. Texas Endosurgery Institute

Aims: The incidence of hernias on the stoma site ranges from 5 to 50% and only 10% of these require surgical treatment. Many kinds of repair for stomal hernias have been proposed. Whatever treatment is chosen, most of the time, the hernia repair surgery is technically difficult and the results commonly disappointing. In this study we describe our technique placing a prosthetic material at the stoma site during the same procedure as the stoma takedown.
Methods: We have been doing so for the last two years, and we have included 62 patients with previous ileostomy or colostomy. All of the surgeries were performed laparoscopically. The bowel is taken down and an intracorporeal anastomosis performed. The stoma defect is closed with non-absorbable suture and a mesh is applied with an IPOM technique using staples and transfascial sutures.
Results: We have not encountered hernias in the patients that underwent this type of approach, and no complications were seen regarding the prosthetic material placement.
Conclusions: The reinforcement of the stoma site with a prosthetic material is safe and feasible and we have seen no hernia incidence in these patients. There were no complications related to the mesh placement, so we consider this a safe complement to any stoma takedown procedure.