Stoma hernia repair

Years have been spent on the search for a good method to repair stoma hernias. To achieve a good, long-term result, a mesh must be placed for reinforcement.

Laparoscopic

Our current view is that the best method for repairing a stoma hernia is keyhole surgery (laparoscopy). For this procedure, we place a large prosthesis over the hernia and the stoma. Our department was the first in Belgium to describe this Modified Sugarbaker technique. We also collaborated on an international study at European centres of expertise to demonstrate the effectiveness of this technique.

Stoma hernia surgery is generally a safe procedure and serious complications are rare.
Possible complications are listed below. The list is not exhaustive but contains the most frequent complications:

• bruises, wound infection and wounds opening up
• bleeding of the abdomen or abdominal wall; this sometimes requires another operation
• infection of the prosthesis
• accidental injury of the bowel or other abdominal organ
• change from keyhole surgery to an open procedure
• Complications that are not directly caused by the surgery: pneumonia, bladder infection, heart rhythm disorders, etcetera
• complications associated with general or epidural anaesthesia
• in the long term, the surgical area will remain painful for some patients
  

Side effects

Some side effects occur very frequently but are no reason for concern:

• Fluid accumulation
  
  After the operation, a swelling often remains for a few weeks where the umbilical hernia was located. This is fluid accumulation (also termed seroma) that usually is not painful but often causes patients concern. This swelling is a normal side effect of the operation. It will slowly disappear of its own accord. If, in exceptional cases, the fluid accumulation causes pain, the surgeon may decide to drain it.

• Bruise
  
  Another common side effect is bruising around the wound. This is no cause for concern either, and it will spontaneously disappear in the weeks following the operation. In case of doubt or concern, feel free to contact your GP or our department.

Can a stoma hernia recur?

A mesh placement reduces the risk of a recurrent stoma hernia. An international study conducted by European centres of expertise, which our Hernia Centre in Ghent collaborated on, found a recurrent stoma hernia in 6.6% of the patients after follow-up of 26 months on average.

For a stoma hernia repair, you should anticipate a hospital stay of two to five days. The first days after the surgery may be quite painful due to the staples used to secure the prosthesis to the abdominal wall. These may cause a sharp pain, especially when sneezing, coughing or pushing. Good pain relief is necessary after the procedure.

We would like you to be active and move around a lot as soon as possible after the operation. We do recommend that you avoid lifting heavy loads and strenuous sport activities for three weeks after the procedure.
After the check-up with the surgeon, three weeks after the operation, you will be able to resume all activities again including lifting and sports.

When you are discharged from the hospital, we will ask you to visit your GP ten days after the procedure to have your wound checked and your sutures removed. In case of problems, you or your GP can of course always contact our department.

A relatively high number of patients with a colostomy irrigate their colon through their stoma. We recommend waiting until six weeks after the surgery to resume this.

The Maria Middelares Hernia Centre in Ghent charges the official RIZIV prices. The invoice will be sent to you by post after a period of approximately three months. In addition to the surgeon's and anaesthesiologist's fee, this will display the general charges for hospital admission and the use of materials such as the mesh.

As is the case in almost any hospital, there is an additional charge for the use of a single room. At the Maria Middelares General Hospital in Ghent, this additional charge is a maximum of 150% of the official price. No additional charges are added to the fee if a multiple-occupancy room is chosen.

Interesting link:

• Ostomy Ilco non-profit

Latest publication date: 15/12/2023