V12-11 LAPAROSCOPIC REPAIR OF ILEAL CONDUIT PARASTOMAL HERNIA USING THE MODIFIED SUGARBAKER TECHNIQUE

You have accessJournal of UrologyBladder Oncology and Diversion1 Apr 2017V12-11 LAPAROSCOPIC REPAIR OF ILEAL CONDUIT PARASTOMAL HERNIA USING THE MODIFIED SUGARBAKER TECHNIQUE Dario Garcia-Rojo, Xavier Serra-Aracil, Angel Prera, Carlos Abad, Jesus Muñoz, Leticia De Verdonces, Marta Capdevila, Eduardo Vicente, Naim Hannaoui, Younes Fadil, Jose Luis Gonzalez-Sala, Arturo Dominguez, Clara Centeno, Victor Parejo, Mario Rosado, Paula Planelles, and Juan Prats Dario Garcia-RojoDario Garcia-Rojo More articles by this author , Xavier Serra-AracilXavier Serra-Aracil More articles by this author , Angel PreraAngel Prera More articles by this author , Carlos AbadCarlos Abad More articles by this author , Jesus MuñozJesus Muñoz More articles by this author , Leticia De VerdoncesLeticia De Verdonces More articles by this author , Marta CapdevilaMarta Capdevila More articles by this author , Eduardo VicenteEduardo Vicente More articles by this author , Naim HannaouiNaim Hannaoui More articles by this author , Younes FadilYounes Fadil More articles by this author , Jose Luis Gonzalez-SalaJose Luis Gonzalez-Sala More articles by this author , Arturo DominguezArturo Dominguez More articles by this author , Clara CentenoClara Centeno More articles by this author , Victor ParejoVictor Parejo More articles by this author , Mario RosadoMario Rosado More articles by this author , Paula PlanellesPaula Planelles More articles by this author , and Juan PratsJuan Prats More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.3217AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Parastomal hernia is a common complication of stoma formation, The reported incidence is variable depending on the degree, the duration of follow-up and the type of stoma. The incidence for ileal conduits ranges from 2% to 6.5%. Modified laparoscopy Sugarbaker technique is a possible method to repair ileal conduit parastomal hernia. METHODS We present a case of the laparoscopic modified Sugarbaker technique applied to repair a ileal conduit parastomal hernia in a 67 years-old patient with a history of radical cystoprostatectomy and Bricker uretero-ileostomy for a bladder cancer seven years ago. The procedure is described in detail in this video. RESULTS The patient was positioned supine with both arms tucked. The abdomen was accessed using a 10-mm trocar in the axillary line, in front of the ileostomy, a 10-mm trocar by subxiphoid approach and a 5-mm trocar in the left lower quadrant. A tedious lysis of adhesions was performed with minimal use of bipolar energy. Liberation of omental adhesions in the foramen of parastomal hernia and extraction of 40 cm. of small bowel located in parastomal hernia were performed. The parastomal hernia defect were identified and measured. We used a 15 cm x 20 cm physiomesh® mesh. The fine filament design and its macroporous structure flexible, facilitate the scar tissue formation and adaptation to the abdominal wall. The mesh was tacked in position to the abdominal wall in its periphery using the 5-mm tacking device. When we place the takers should make an external pressure on the abdominal wall. Several takers are placed in the abdominal wall, circumferentially around the ileal loop. The patient was discharged after a 2-day stay. After 20 months of follow up, the patient is free of recurrence of parstomal hernia. CONCLUSIONS The introduction of prosthetic meshes significantly decreases the recurrence rates of parastomal hernia. Laparoscopic surgery reduces postoperative pain, recovery time and minimize many of the morbidities associated with open procedures. Laparoscopic parastomal hernia repair has a viable option to overcome the challenges that face the hernia surgeon. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1375 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Dario Garcia-Rojo More articles by this author Xavier Serra-Aracil More articles by this author Angel Prera More articles by this author Carlos Abad More articles by this author Jesus Muñoz More articles by this author Leticia De Verdonces More articles by this author Marta Capdevila More articles by this author Eduardo Vicente More articles by this author Naim Hannaoui More articles by this author Younes Fadil More articles by this author Jose Luis Gonzalez-Sala More articles by this author Arturo Dominguez More articles by this author Clara Centeno More articles by this author Victor Parejo More articles by this author Mario Rosado More articles by this author Paula Planelles More articles by this author Juan Prats More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...