24/11/2025
Sharing a case of parastomal hernia around an ileostomy, I operated recently . 🩺
In patients with re**al cancer, ileostomies are often created to divert intestinal contents and protect the site of anastomosis ( where colon is reconnected with remaining re**um, after removal of cancer; often with the help of a stapler).
Sometimes ileostomy can lead to a parastomal hernia, where abdominal contents herniate through the opening made on the abdomen wall to bring out the stoma.
In this case, the stoma closure was due, so hernia repair was performed simultaneously with ileostomy reversal.
As you can see , the defect in the abdomen wall, measured around 6 cm horizontally and even more vertically. Such a defect should not be closed in a routine fashion (i.e. in one layer ) because it will lead to a second hernia in future.
So, i used a component separation method to close this defect. In this method the muscle layers are of the abdomen are separated, which gives them more mobility. This in turn helps to close the defect without tension on the tissues .
While the upper part of the repair was well-covered by the separated muscles, the lower part of the defect was close to the groin and did not have adequate muscle cover.
The whole area was reinforced with a mesh to prevent a second hernia in future.
The skin was then approximated using a purse-string technique.
✅ Outcome: Successful ileostomy reversal with parastomal hernia repair in the same setting.
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{Hernia, Ileostomy, Stoma, Hernia Repair, Colore**al, Abdominal Surgery, Re**al Cancer, Surgical Procedure,Parastomal Hernia, Stoma Reversal, Ileostomy Reversal, Hernia Repair Surgery, Laparoscopic Surgery, Surgical Education, Surgery Success}
