PMC8173221_01
Pre-operative CT scan showing parastomal hernia (yellow arrow).
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F1
Computed tomography (CT) examination revealed a parastomal hernia (Figure 1) with a diameter of 3 cm.
Layout of the trocar placement.
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F2
To create the preperitoneal space, 2 sets of 5-mm trocars were inserted at the site of surgical incision using the retrograde puncture technique; the trocars were placed at ~5 cm to each side of the incision, and a 12-mm observation trocar was placed through the incision (Figure 2).
Anatomic relationship at the end of peritoneal dissociation.
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F3
Through the space that was created by separation, we enlarged the extraperitoneal space within a 15- to 20-cm radius around the stoma, providing a large field for mesh placement (Figure 3).
Intraoperative picture of hernia ring closure.
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F4
At the end of the procedure, the abdominal wall defect was closed with a 2-0 non-absorbable suture (Figure 4).
Mesh placement.
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F5
A 15 x 15-cm polypropylene mesh was cut in the middle and placed around the colostomy loop (Figure 5), then sutured and fixed.
Post-operative CT image showing no recurrence of hernia (yellow arrow).
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F6
The follow-up abdominal CT scan showed no recurrence of the hernia (Figure 6).