Clinical analysis of 18 cases with parastomal hernia treated by robotic and laparoscopic surgery

doi:10.3877/cma.j.issn.1674-0793.2022.05.005

Abstract

Abstract:

Objective

To explore the application of robotic and laparoscopic minimally invasive surgery in parastomal hernia repair.

Methods

The data of 18 patients who underwent parastomal hernia tension-free repair using robotic and laparoscopic minimally invasive surgery from April 2018 to April 2022 in Fujian Medical University Union Hospital were retrospectively analyzed. The operation time, intraoperative bleeding, recovery time of eating, postoperative incision infection, paralytic intestinal obstruction, drainage tube extraction time, hospital stay, and long-term follow-up indicators including recurrence, patch infection, and chronic pain were recorded and compared between the two groups.

Results

Tension-free repair of parastomal hernia was successfully completed in 18 cases, and 4 cases (22.2%) underwent stoma reconstruction. Sugarbaker method was performed in 13 cases (72.2%), of which 2 cases used robotic surgery and 11 cases used laparoscopic surgery. Keyhole method was performed in 5 cases (27.7%), of which 1 case used robotic surgery and 4 cases used laparoscopic surgery. The mean operative time was 191-406 min, with an average of (276.8±71.3) minutes. Intraoperative blood loss was 20-100 ml, with an average of (29.3±22.2) ml. Liquid diet was resumed on the second day after operation, and semi-liquid diet was taken on the third day. The drainage tube was placed and removed 5-7 days after the operation. The routine abdominal girdle was restrained for 3-6 months. The postoperative hospital stay was 3-19 days, with an average of (8.2±4.7) days. Postoperative recurrence occurred in 1 case (5.6%), incision infection in 1 case (5.6%), paralytic intestinal obstruction in 3 cases (16.7%), pulmonary infection in 6 cases (33.3%), and incision infection and paralytic intestinal obstruction were cured and discharged after non-surgical treatment. There was no recurrence, patch infection or chronic pain during the follow-up period.

Conclusion

The tension-free repair of parastomal hernia using robotic system and laparoscopic surgery is safe and feasible, with few perioperative complications, fast postoperative recovery, and definite curative effects.

Key words: Parastomal hernia, Da Vinci surgical system, Robotic surgery, Laparoscopic surgery

Yuanyuan Yang, Heguang Huang, Yanchang Chen, Fengchun Lu, Xianchao Lin, Ronggui Lin, Congfei Wang. Clinical analysis of 18 cases with parastomal hernia treated by robotic and laparoscopic surgery[J]. Chinese Archives of General Surgery(Electronic Edition), 2022, 16(05): 336-340.

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References 22

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