{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T14:58:35Z","timestamp":1782572315310,"version":"3.54.5"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,10,5]],"date-time":"2021-10-05T00:00:00Z","timestamp":1633392000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p><jats:bold>Purpose:<\/jats:bold> Many patients develop a parastomal hernia within the first 2 years of stoma formation, and even surgical repair is associated with high recurrence rates. An intraperitoneal approach is typically used for the laparoscopic repair of parastomal hernia; it is unknown whether a totally extraperitoneal technique (TEP) is feasible. Here we describe a laparoscopic TEP approach using a modified Sugarbaker method for the repair of parastomal hernia.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Seven patients underwent parastomal hernia repair. The retrograde puncture technique was used to create the extrapneumoperitoneum, and the peritoneum was separated with a laparoscopic TEP approach; the mesh was placed using a modified Sugarbaker technique.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> All patients had an oncologic etiology for stoma creation. The mean (\u00b1SD) size of the hernia defect was 3.1 \u00b1 2.7 cm and the mesh size was 303.4 \u00b1 96.8 cm<jats:sup>2<\/jats:sup>. The mean operative time was 195.5 \u00b1 20.7 min and average length of hospital stay after surgery was 4.8 \u00b1 2.1 days. One patient had intraoperative subcutaneous emphysema. The average follow-up time was 8.5 \u00b1 2.7 months; mild pain occurred in 2 patients, 3 experienced seroma formation (with no special treatment required), and 1 had early intestinal obstruction (which was treated with conservative care). There was no hernia recurrence, wound complications, or infections of the surgical site or mesh during follow-up.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> A laparoscopic TEP technique is technically challenging but feasible. Modified laparoscopic Sugarbaker repair of a parastomal hernia with the TEP technique is safe and effective, although the recurrence rate and late complications require confirmation in more cases with long-term follow-up.<\/jats:p>","DOI":"10.3389\/fsurg.2021.740430","type":"journal-article","created":{"date-parts":[[2021,10,8]],"date-time":"2021-10-08T06:24:39Z","timestamp":1633674279000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Modified Laparoscopic Sugarbaker Repair of Parastomal Hernia With a Totally Extraperitoneal Technique"],"prefix":"10.3389","volume":"8","author":[{"given":"Huiyong","family":"Jiang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dil Momin","family":"Thapa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangjun","family":"Cai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mofei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,10,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1007\/s10029-017-1697-5","article-title":"European hernia society guidelines on prevention and treatment of parastomal hernias","volume":"22","author":"Antoniou","year":"2018","journal-title":"Hernia."},{"key":"B2","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1007\/s10029-020-02161-2","article-title":"Outcomes of surgically managed recurrent parastomal hernia: the sisyphean challenge of the hernia world","volume":"25","author":"Harries","year":"2021","journal-title":"Hernia."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1742","DOI":"10.1007\/s00268-021-05990-z","article-title":"Parastomal hernia: a retrospective nationwide cohort study comparing different techniques with long-term follow-up","volume":"45","author":"M\u00e4k\u00e4r\u00e4inen-Uhlb\u00e4ck","year":"2021","journal-title":"World J Surg."},{"key":"B4","doi-asserted-by":"publisher","first-page":"224","DOI":"10.4103\/jmas.JMAS_17_18","article-title":"Laparoscopic parastomal hernia repair: a modified technique of mesh placement in sugarbaker procedure","volume":"15","author":"Rege","year":"2019","journal-title":"J Minim Access Surg."},{"key":"B5","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.ijscr.2020.04.082","article-title":"Modified keyhole technique for the treatment of parastomal hernia: a case series","volume":"71","author":"Ando","year":"2020","journal-title":"Int J Surg Case Rep."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1863","DOI":"10.1007\/s00464-020-07589-2","article-title":"From keyhole to sandwich: change in laparoscopic repair of parastomal hernias at a single centre","volume":"35","author":"Bertoglio","year":"2021","journal-title":"Surg Endosc."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1140","DOI":"10.1002\/bjs.7082","article-title":"Adverse effects of polyvinylidene fluoride-coated polypropylene mesh used for laparoscopic intraperitoneal onlay repair of incisional hernia","volume":"97","author":"Fortelny","year":"2010","journal-title":"Br J Surg."},{"key":"B8","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1016\/j.amjsurg.2010.08.019","article-title":"Long-term outcomes of laparoscopic totally extraperitoneal inguinal hernia repairs performed by supervised surgical trainees","volume":"201","author":"Zendejas","year":"2011","journal-title":"Am J Surg."},{"key":"B9","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1016\/j.ijscr.2016.09.053","article-title":"Laparoscopic totally extra-peritoneal hernia repair for bilateral Spigelian hernias and coincident inguinal hernia: a case report","volume":"28","author":"Matsui","year":"2016","journal-title":"Int J Surg Case Rep."},{"key":"B10","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1007\/s00464-002-8557-8","article-title":"Totally extraperitoneal laparoendoscopic repair of lumbar hernia","volume":"17","author":"Meinke","year":"2003","journal-title":"Surg Endosc."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1543","DOI":"10.1007\/s00464-018-6568-3","article-title":"Totally endoscopic sublay (TES) repair for midline ventral hernia: Surgical technique and preliminary results","volume":"34","author":"Li","year":"2020","journal-title":"Surg Endosc."},{"key":"B12","doi-asserted-by":"publisher","first-page":"659102","DOI":"10.3389\/fsurg.2021.659102","article-title":"Endoscopic totally extraperitoneal repair of parastomal hernia: a case report","volume":"8","author":"Jiang","year":"2021","journal-title":"Front Surg."},{"key":"B13","doi-asserted-by":"publisher","first-page":"e5247","DOI":"10.1590\/1414-431x20165247","article-title":"Novel retrograde puncture method to establish preperitoneal space for laparoscopic direct inguinal hernia repair with internal ring suturing","volume":"49","author":"Jiang","year":"2016","journal-title":"Braz J Med Biol Res."},{"key":"B14","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1046\/j.1463-1318.2003.00403.x","article-title":"A prospective audit of stomas-analysisof risk factors and complications and their management","volume":"5","author":"Arumugam","year":"2003","journal-title":"Colorectal Dis."},{"key":"B15","doi-asserted-by":"publisher","first-page":"837","DOI":"10.1007\/s10029-018-1795-z","article-title":"Early operative outcomes of endoscopic (eTEP access) robotic-assisted retromuscular abdominal wall hernia repair","volume":"22","author":"Belyansky","year":"2018","journal-title":"Hernia."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1903","DOI":"10.1007\/s00464-020-08192-1","article-title":"Endoscopic preperitoneal parastomal hernia repair (ePauli repair): an observational study","volume":"35","author":"Lambrecht","year":"2021","journal-title":"Surg Endosc."},{"key":"B17","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1007\/s10029-016-1489-3","article-title":"How i do it: novel parastomal herniorrhaphy utilizing transversus abdominis release","volume":"20","author":"Pauli","year":"2016","journal-title":"Hernia."},{"key":"B18","doi-asserted-by":"publisher","first-page":"170","DOI":"10.3892\/mco.2016.1112","article-title":"Comparison of laparoscopic vs. open surgery for rectal cancer","volume":"6","author":"Ding","year":"2017","journal-title":"Mol Clin Oncol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1094","DOI":"10.1177\/0310057X1003800622","article-title":"Surgical emphysema as a cause of severe hypercapnia during laparoscopic surgery","volume":"38","author":"Critchley","year":"2010","journal-title":"Anaesth Intensive Care."},{"key":"B20","doi-asserted-by":"publisher","first-page":"rjz415","DOI":"10.1093\/jscr\/rjz415","article-title":"Subcutaneous emphysema and hypercarbia as a complication of laparoscopic procedure: case report","volume":"2020","author":"Aldakhil","year":"2020","journal-title":"J Surg Case Rep"},{"key":"B21","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1007\/BF03011692","article-title":"Laparoscopic extraperitoneal inguinal hernia repair complicated by subcutaneous emphysema","volume":"42","author":"Klopfenstein","year":"1995","journal-title":"Can J Anaesth."},{"key":"B22","doi-asserted-by":"publisher","first-page":"941","DOI":"10.1007\/s10029-017-1644-5","article-title":"Single parastomal hernia repair","volume":"21","author":"Tastaldi","year":"2017","journal-title":"Hernia."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1456","DOI":"10.1007\/s00464-008-0253-x","article-title":"Laparoscopic parastomal hernia repair using a keyhole technique results in a high recurrence rate","volume":"23","author":"Hansson","year":"2009","journal-title":"Surg Endosc."}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2021.740430\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,8]],"date-time":"2021-10-08T06:24:41Z","timestamp":1633674281000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2021.740430\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,5]]},"references-count":23,"alternative-id":["10.3389\/fsurg.2021.740430"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2021.740430","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,5]]},"article-number":"740430"}}