Video-assisted preperitoneal repair of parastomal hernia

Parastomal hernia repair is still an unresolved surgical problem, associated with high rate of recurrence and morbidity. Conventional methods with use of a mesh require extensive tissue preparation with significant traumatization. Meanwhile, a substantial problem of the laparoscopic approach is division of intestinal adhesions with risk of their iatrogenic injury. Therefore preperitoneal video-assisted repair seems the best option. This technique, preserving the advantage of minimal tissue traumatization, does not necessitate separation of adhesions in the peritoneum. For a selected group of patients with parastomal hernia it can become a profitable alternative. Video-assisted preperitoneal parastomal hernia repair was performed in a patient with parastomal hernia type IV, according to Devlin’s classification, and a history of three laparotomies.