Peritoneal approach to prosthetic mesh repair of paraostomy hernias.

A new method for repair of large hernias at stoma sites is presented. The old abdominal incision is reopened and prosthetic mesh is sutured in place aseptically. The bowel courses above the mesh to be secured to the lateral abdominal wall creating a flap valve. Seven paraostomy hernia repairs in six patients were performed with no recurrences in a 4- to 7-year follow-up. The peritoneal approach to insertion of prosthetic mesh into the hernia defect is recommended especially for recurrent paraostomy hernias. This technique is appropriate for a hernia that possesses a large fascial defect.