Clinical Challenges in Hernia Surgery: Parastomal Hernias
Behind The Knife: The Surgery Podcast
Behind The Knife: The Surgery Podcast
4.8 • 1.4K Ratings
🗓️ 12 September 2024
⏱️ 37 minutes
🧾️ Download transcript
Summary
Hosts:
- Ajita Prabhu, MD, Cleveland Clinic, @aprabhumd1
- Lucas Beffa, MD, Cleveland Clinic, @BeffaLukeMD
- Ryan Ellis, MD, Cleveland Clinic, @EllisMD2020
- Sara Maskal, MD, Cleveland Clinic
Learning Objectives:
- Review anatomy of parastomal abdominal wall hernias
- Review perioperative pitfalls and tips for staying out of trouble
- Review common surgical approaches to repair
References:
- Maskal SM, Ellis RC, Miller BT. Parastomal hernia repair, trying to optimize the impossible reconstruction. Hernia. 2024 Apr 28:1-6. https://pubmed.ncbi.nlm.nih.gov/38678529/
- Maskal SM, Thomas JD, Miller BT, Fafaj A, Zolin SJ, Montelione K, Ellis RC, Prabhu AS, Krpata DM, Beffa LR, Costanzo A. Open retromuscular keyhole compared with Sugarbaker mesh for parastomal hernia repair: Early results of a randomized clinical trial. Surgery. 2024 Mar 1;175(3):813-21.
https://pubmed.ncbi.nlm.nih.gov/37770344/
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Transcript
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| 0:00.0 | Behind the surgery podcast relevant and engaging content designed to help you dominate the day. |
| 0:13.0 | Hello and welcome to another episode of Behind the Knife with the |
| 0:24.7 | hernia team at Cleveland Clinic. I'm Sarah Maskell here with the rest of my |
| 0:28.3 | team. Ryan Ellis, General Surgery resident at the Cleveland Clinic. Loucivalveau, Assistant Professor of Surgery. |
| 0:35.0 | Ajita Pervu, Professor of Surgery. |
| 0:38.0 | Today we're going to talk about a complex topic in hernia surgery, Parastoma |
| 0:42.0 | hernias. |
| 0:43.0 | So to start off, we want to go through some of the preoperative considerations. |
| 0:47.0 | Considering the high prevalence of parastomal hernias, |
| 0:50.0 | what are the signs and her symptoms that prompt you to offer patients |
| 0:52.8 | parastomal hernia repair? |
| 0:54.8 | That's a great question. |
| 0:55.7 | We see patients in the office all the time |
| 0:57.9 | that have newly diagnosed parastomal hernias. |
| 1:01.1 | I would say, first of all, it's important to establish why you're |
| 1:04.3 | operating on these patients to begin with. Unlike other types of herneas I would say |
| 1:09.3 | I tend to stray away from operating on patients if they don't have symptoms for this type of |
| 1:14.8 | hernia because they really do have a high recurrence rate post-operatively if you follow them out. |
| 1:20.5 | So for me at least, when I see them in the the office the first things that I want to know are if they have pain around the stoma if they are having difficulty pouching their stoma so if they're having leakage related to the contour so one of the things I |
| 1:36.9 | want to know is if they're having leakage around or underneath their pouch and |
| 1:40.8 | having difficulty pouching as a result due to the contour of their abdominal their I think any of those things if they're having difficulty pouching if they're having pain or if they're having constructive symptoms those for me are good indications to go to the operating room. |
| 1:59.8 | Yeah, I think that's a great summary and great introduction to it. |
... |
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