Zia Khawaja, McGowan David Ross, Moore Etienne
Department of General Surgery, Brighton and Sussex University Hospital NHS Trust, Brighton, UK.
BMJ Case Rep. 2013 Jun 18;2013:bcr2013010162. doi: 10.1136/bcr-2013-010162.
Parastomal hernia is a recognised complication following stoma formation, representing a challenging problem to surgeons. At least three approaches for parastomal hernia repair have been described: fascial suture repair, relocation of stoma and local repair with use of mesh. In simple fascial suture repair only open techniques have been described. Relocation of stoma can be complicated with another parastomal hernia at the new site and risk of incisional hernia at the site of previous stoma. Mesh repair can be either open or laparoscopic. The recurrence rate and complications of parastomal hernia repair remain very high. We have invented a simple fascial suture laparoscopic repair of parastomal hernia with the use of the Crochet hook needle (EndoClose). This new technique may result in reduced pain, earlier discharge from hospital and reduced risk of infection as there is no mesh used as well as reduced risk of seroma formation.
造口旁疝是造口形成后公认的并发症,对外科医生来说是一个具有挑战性的问题。目前已描述了至少三种造口旁疝修补方法:筋膜缝合修补、造口重新定位和使用补片的局部修补。在简单的筋膜缝合修补中,仅描述了开放技术。造口重新定位可能会在新部位并发另一个造口旁疝,并在先前造口部位有发生切口疝的风险。补片修补可以是开放的或腹腔镜的。造口旁疝修补的复发率和并发症仍然很高。我们发明了一种使用钩针(EndoClose)的简单筋膜缝合腹腔镜造口旁疝修补术。这项新技术可能会减轻疼痛、使患者更早出院、降低感染风险(因为未使用补片)以及降低血清肿形成的风险。