TY - JOUR
T1 - Stapled Transabdominal Ostomy Reinforcement with retromuscular mesh (STORRM)
T2 - Technical details and early outcomes of a novel approach for retromuscular repair of parastomal hernias
AU - Majumder, Arnab
AU - Orenstein, Sean B.
AU - Miller, Heidi J.
AU - Novitsky, Yuri W.
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2018/1
Y1 - 2018/1
N2 - Background Parastomal hernia repair (PHR) remains a challenge with no optimal repair technique. During retromuscular hernia repair, traversing the stomal conduit through the abdominal wall can result in angulation and compression. Widening of traditional cruciate incisions in mesh and/or fascia likely contributes to recurrences. To address these pitfalls, the Stapled Transabdominal Ostomy Reinforcement with Retromuscular Mesh (STORRM) technique utilizing a circular stapler was developed. Methods A prospective registry of consecutive patients undergoing STORRM was analyzed. We characterized demographics, hernia characteristics, and perioperative results. Primary outcomes were complications, surgical site events (SSEs) and hernia recurrence. Results 12 patients underwent PHR with STORRM; mean age 64 and BMI 36 kg/m2. Synthetic mesh was used in 92% of patients. We observed two (17%) SSEs, one case of cellulitis and one organ space infection. With mean 12.8-month follow-up, we documented two recurrences. Conclusions STORRM represents a safe method to repair parastomal hernias. The unified aperture with stapled reinforcement results in reproducible repairs, minimizing intestinal angulation associated with traditional stoma passage. Early outcomes evidenced minimal complications and favorable recurrence rate.
AB - Background Parastomal hernia repair (PHR) remains a challenge with no optimal repair technique. During retromuscular hernia repair, traversing the stomal conduit through the abdominal wall can result in angulation and compression. Widening of traditional cruciate incisions in mesh and/or fascia likely contributes to recurrences. To address these pitfalls, the Stapled Transabdominal Ostomy Reinforcement with Retromuscular Mesh (STORRM) technique utilizing a circular stapler was developed. Methods A prospective registry of consecutive patients undergoing STORRM was analyzed. We characterized demographics, hernia characteristics, and perioperative results. Primary outcomes were complications, surgical site events (SSEs) and hernia recurrence. Results 12 patients underwent PHR with STORRM; mean age 64 and BMI 36 kg/m2. Synthetic mesh was used in 92% of patients. We observed two (17%) SSEs, one case of cellulitis and one organ space infection. With mean 12.8-month follow-up, we documented two recurrences. Conclusions STORRM represents a safe method to repair parastomal hernias. The unified aperture with stapled reinforcement results in reproducible repairs, minimizing intestinal angulation associated with traditional stoma passage. Early outcomes evidenced minimal complications and favorable recurrence rate.
KW - Abdominal wall reconstruction
KW - Parastomal hernia repair
KW - Retromuscular
KW - Stapled
KW - Transversus abdominis release
KW - Ventral hernia repair
UR - http://www.scopus.com/inward/record.url?scp=85025675346&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2017.07.030
DO - 10.1016/j.amjsurg.2017.07.030
M3 - Article
C2 - 28754535
AN - SCOPUS:85025675346
SN - 0002-9610
VL - 215
SP - 82
EP - 87
JO - American journal of surgery
JF - American journal of surgery
IS - 1
ER -