Laparoscopic Total Extraperitoneal Repair for Parastomal Hernia A Modified Approach to Sugabeckers Operation Aiming for Safer Surgery and Faster Recovery

What this Trial Is About

Parastomal hernia is a common complication following stoma surgery that poses significant challenges due to high recurrence rates and impacts patient quality of life. This research investigates a laparoscopic total extraperitoneal TEP technique as a modification of the traditional Sugabeckers operation. The study aims to assess the feasibility, safety, and recurrence rates of this minimally invasive approach compared to standard methods. The study involves two groups of patients with parastomal hernias one receiving the traditional Sugarbaker procedure with intraperitoneal onlay mesh IPOM placement, and the other undergoing the modified laparoscopic TEP repair where mesh is placed entirely in the extraperitoneal space. The laparoscopic TEP method includes a unilateral transrectal incision and creation of a preperitoneal or retro-rectus space to position the mesh. This approach is expected to reduce operative trauma and complications compared to the open method. Participants will be monitored for intraoperative complications, postoperative pain, infectious complications, length of hospital stay, and hernia recurrence over a follow-up period of up to one year. Quality of life will be assessed using the SF-36 survey at multiple time points. Early mobilization and recovery will be encouraged, with routine activities expected to resume within two weeks. The primary outcome is the hernia recurrence rate at one year post-operation, along with secondary measures including infection rates, pain levels, hospital stay length, and quality of life improvements.

Laparoscopic Total Extraperitoneal Plasty as a Modification of Sugabecker's Operation