Laparoscopic stoma formation with a prophylactic prosthetic mesh

Background One year after stoma formation with an open technique, the rate of parastomal hernia is almost 50%. The herniation rate can be reduced to 10% with the use of a prophylactic mesh in a sublay position. For stomas formed with a laparoscopic technique, a surgical method with the use of prophylactic mesh should be sought. Methods Patients with a sigmoidostomy created with a laparoscopic technique were provided with a prophylactic large-pore, low-weight mesh in a sublay position. Follow-up examination was carried out after at least 12 months. Results Between March 2003 and May 2007, a sigmoidostomy was created in 25 patients. The patients’ mean age was 65 years (range 31–89), the mean body mass index was 26 (range 21–32) and 15 were female. One stoma necrosis and two minor wound infections occurred. Parastomal hernia was present in 3 of 20 patients (15%) available for follow-up examination after 11–31 months (mean 19). No fistulas or strictures had developed. No mesh infection was noted and no mesh was removed. Conclusion In laparoscopic stoma formation, a prophylactic large-pore, low-weight mesh in a sublay position is an easy and safe procedure associated with a low rate of parastomal hernia.