Prevention of parastomal hernias by prophylactic use of a specially designed intraperitoneal onlay mesh (Dynamesh IPST).

BACKGROUND: Hernias around ostomies are a very common complication, exceeding 50%. Only a few studies deal with the prophylactic use of mesh to prevent parastomal hernia revealing promising results.

PATIENTS AND METHODS: Twenty-two patients undergoing elective rectal surgery with a permanent colostomy--one with an ileostomy and two needing surgical correction of a preexisting colostomy--were enrolled in a prospective study. A specially designed mesh made of polyvinylidene fluoride with a central whole and a funnel arising (Dynamesh IPST) was prophylactically implanted using an intraperitoneal onlay technique. The patients were followed for a median of 11 (range 2-19) months by clinical examination every 3 months.

RESULTS: No infection or any other adverse effect was observed, and no parastomal hernia or stoma protrusion could be detected clinically. Twelve patients had a routine computed tomography after 6 months, which also excluded any hernia formation.

CONCLUSION: The prophylactic use of Dynamesh IPST) is a safe and effective procedure preventing stoma complications such as hernia formation or prolapse, at least in the short run.