Question: Seeking Insights on Parastomal Hernia and Surgical Outcomes

I’ve had an ostomy since 2016 and experienced an obstruction from a hernia last year. My laparoscopic parastomal hernia surgery in January 2020 was altered due to scar tissue, and now the hernia has recurred. I’m facing another surgery, potentially with mesh placement or moving the stoma. I’m interested in understanding the commonality of such issues and others’ experiences with similar surgeries.

Response: Navigating Parastomal Hernia and Surgical Repair Options

Parastomal hernias are a frequent complication following abdominal ostomy surgeries. The incidence varies but is significantly high, with estimates suggesting over 30% within the first year, 40% by two years, and 50% or more over longer periods. Some studies even indicate up to 78% occurrence rate within two years post-surgery.

Surgical Repair Methods:

  1. Closing the Stoma: This option is viable for individuals with sufficient healthy bowel for reattachment.
  2. Hernia Repair Surgery: Involves opening the abdominal wall, sewing muscle and tissues to narrow/close the hernia. This method is most effective for smaller hernias.
  3. Stoma Relocation: For some, closing the existing stoma and creating a new one in a different abdominal area is an option. However, there’s a risk of a new parastomal hernia forming around the new stoma.
  4. Mesh Insertion: Currently, the most common approach involves using either synthetic or biological mesh. The mesh is placed over or under the abdominal wall after hernia repair, strengthening the area to prevent recurrence. Biological mesh is often considered more comfortable and integrates into the surrounding tissue for added support.

Considerations and Recovery:

  • It’s important to discuss all options with your surgeon, considering the size and location of the hernia, your overall health, and previous surgical history.
  • Recovery and success rates vary based on the chosen method and individual circumstances.

I hope this information provides clarity and helps in your decision-making process. Wishing you a smooth surgery and a speedy recovery.

Jo-Ann L. Tremblay
THE OSTOMY FACTOR Blog – joannltremblay.wordpress.com
Author & Ostomy Lifestyle Expert, Ostomy Canada
Member, Arteast – www.arteastottawa.com
Website: jo-annltremblay.com

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