AUTHOR=Bloemendaal A. L. A. 

TITLE=Robotic Retromuscular (Recurrent) Parastomal Hernia Repair (r-Pauli-Repair) With Synthetically Reinforced Biological Mesh; Technique, Early Experience, and Short-Term Follow-Up

JOURNAL=Journal of Abdominal Wall Surgery

VOLUME=2

YEAR=2023

URL=https://www.frontierspartnerships.org/journals/journal-of-abdominal-wall-surgery/articles/10.3389/jaws.2023.12059

DOI=10.3389/jaws.2023.12059

ISSN=2813-2092

ABSTRACT=<p><bold>Introduction:</bold> Parastomal hernia repair remains a challenge. We describe a robotic retromuscular non-keyhole mesh repair using a synthetically reinforced biological mesh (Ovitex) for the repair of complex and/or recurrent parastomal hernia and technical modifications we made along the way to improve our technique.</p><p><bold>Methods:</bold> All patients underwent the described retromuscular parastomal hernia repair. Data was collected in a database and a retrospective analysis was performed on direct postoperative results and early follow-up.</p><p><bold>Results:</bold> Eleven patients underwent the operation. Median follow-up was 12 months. Median LOS was 6 days. Two recurrences occurred. One patient suffered postoperative hematoma and skin necrosis, which healed completely, but did lead to a recurrence. One patient had a significant seroma, which subsided without intervention. Both recurrences were reoperated, and a local repair was performed.</p><p><bold>Conclusion:</bold> This paper is the first to describe a modified robotic Pauli repair for complex and recurrent parastomal hernia, using a synthetically reinforced biological mesh. Results are satisfying so far, especially considering the complexity of the cases.</p>