Repair of Parastomal Hernia with Component Separation at Reversal of Loop Ileostomy. A technical note.

ABSTRACT

AIM: The aim of this technical note is to describe a surgical technique to repair parastomal hernias with component separation and mesh at reversal of loop ileostomy. BACKGROUND: Stage III rectal cancer patients who have completed neoadjuvant chemoradiation will undergo low anterior resection with loop ileostomy. Following completion of adjuvant chemotherapy, the ileostomy will be reversed after an average of five to six months. A minority of patients presenting with an obstructed rectal cancer may undergo laparoscopic loop ileostomy prior to commencing neoadjuvant chemoradiation, resulting in a longer ileostomy time. TECHNIQUE Loop ileostomy reversal consists of five steps: mobilization of the stoma, side-to-side anastomosis, component separation, placement of biologic mesh, and purse-string skin closure. CONCLUSION: The surgical technique described here, consisting of component separation and mesh at loop ileostomy reversal, is effective for repairing parastomal hernia.