{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T17:03:13Z","timestamp":1781629393092,"version":"3.54.5"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Hernia"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Parastomal hernias are a common and complex problem for patients and their surgeons. Despite multiple established repair strategies, recurrence rates remain high. We present a novel open retromuscular repair technique using a 3D funnel mesh.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The technique involves retrorectus dissection, transversus abdominis release (TAR), lateralisation of the stomal conduit, and retromuscular placement of a 3D funnel mesh. A second flat mesh reinforces the remaining retromuscular space. Abdominoplasty was performed where excess skin or fat contributed to the parastomal \u2018bulge\u2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifteen patients underwent repair (median age 59 years, BMI 33.8\u00a0kg\/m\u00b2). Nine had a colostomy and six an ileostomy. Five (33%) had a recurrent parastomal hernia, and 13 (87%) had concomitant incisional hernia. The median combined transverse defect width was 11.9\u00a0cm (IQR 10.4\u201312.2). Abdominoplasty was performed in 13 patients (87%). At median 15-month follow-up, no recurrences, stenoses, or obstructions were observed. Complications included wound infection (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092), seroma (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091), abscess (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091), stoma prolapse (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091), and stoma retraction (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091). Two patients required stoma refashioning.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The retromuscular 3D funnel mesh technique offers a robust repair with potential advantages over other recognized repair options. It also addresses the peristomal \u2018bulge\u2019 of redundant skin and excess subcutaneous fat that can compromise stoma appliance application and adherence. Comparative studies focused on patient reported outcome measures are needed to determine if this technique confers advantages over other established procedures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10029-025-03543-0","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T06:29:20Z","timestamp":1767940160000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Parastomal hernia repair using retromuscular 3D funnel mesh: the \u201cSugar Funnel\u201d technique"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0965-9773","authenticated-orcid":false,"given":"Alaa","family":"Soliman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaurav V.","family":"Kulkarni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Barnes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toby M.","family":"Hammond","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,9]]},"reference":[{"key":"3543_CR1","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1007\/s10029-017-1697-5","volume":"22","author":"SA Antoniou","year":"2018","unstructured":"Antoniou SA, Agresta F, Garcia Alamino JM, Berger D, Berrevoet F, Brandsma HT et al (2018) European hernia society guidelines on prevention and treatment of parastomal hernias. 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Ethical standards were observed throughout, and written informed consent was obtained from all patients.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"This study involved human participants only. Written informed consent was obtained from all patients for the surgical procedure and inclusion of anonymized data and intra-operative images in this publication. No animals were involved in this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and animal rights"}},{"value":"TMH declares conflict of interest not directly associated with this work. TMH has received honorarium from Gore as an invited speaker at industry symposia. The other authors declare that they have no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"57"}}