# The Local Parastomal Hernia (LoPa) Repair: A Novel Approach to Parastomal Hernia Repair

## TL;DR

A new surgical technique called LoPa for repairing parastomal hernias shows promising short-term safety and recovery outcomes, though it has a notable recurrence rate.

## Contribution

The LoPa repair is a novel surgical technique using a retromuscular mesh with an outward-facing collar for parastomal hernia repair.

## Key findings

- The LoPa technique had a 33.3% recurrence rate at a median follow-up of 47 months.
- Patients had low short-term morbidity and a median hospital stay of 3 days.
- Postoperative health status was comparable to the general population, though recurrence was linked to increased pain and anxiety.

## Abstract

Surgical repair of parastomal hernias (PH) is challenging, mainly due to high recurrence rates. The Local Parastomal repair (LoPa) is a novel technique utilizing a retromuscular synthetic mesh with an outward-facing collar. This study describes the LoPa technique and evaluates its outcomes.

This single-centre study retrospectively reviewed 39 consecutive patients who underwent LoPa repair for a PH between 2017 and 2021. Long-term follow-up, including physical examination and quality of life assessment, was conducted. The primary outcome was PH recurrence diagnosed clinically or by CT scan.

For the 39 patients included, the mean age and BMI were 71 years and 27 kg/m2, respectively. The most common ASA score was III (48.7%). The median length of stay was 3 days with no Clavien-Dindo ≥4 complications observed. At a median follow-up of 47 months, the overall recurrence rate was 33.3% (12/36 patients). Postoperative general health status was comparable to the Swedish general population, though recurrence was associated with more pain and anxiety.

The LoPa technique is a safe and feasible PH repair, offering low short-term morbidity and a short length of stay. It is an option for repairing isolated PH, especially in patients with comorbidities. While the 33.3% recurrence rate is a concern, it is comparable to other techniques with similar follow-up. These preliminary findings warrant validation in larger prospective trials.