# Recurrent Parastomal Hernia Treated With Stoma Relocation and Abdominal Lipectomy: A Case Report

## TL;DR

A 75-year-old woman with a recurrent parastomal hernia was successfully treated with open abdominal wall reconstruction, including stoma relocation and mesh reinforcement.

## Contribution

This case report presents a successful open surgical approach for complex recurrent parastomal hernia when laparoscopic methods fail.

## Key findings

- Laparoscopic Sugarbaker repair failed within six months for a patient with recurrent parastomal hernia.
- Open reconstruction with stoma relocation and biosynthetic mesh showed no recurrence at six weeks.
- Dense adhesions made retromuscular mesh placement impossible, necessitating an onlay approach.

## Abstract

Parastomal hernia (PSH) remains a challenging complication following stoma formation, with recurrence rates remaining high despite advances in surgical techniques, including laparoscopic approaches. Recurrent PSH often necessitates complex reconstructive procedures to restore abdominal wall integrity.

We report the case of a 75-year-old female with a history of abdominoperineal resection and permanent end colostomy for rectal cancer who developed a PSH nine years after her initial surgery. She underwent a laparoscopic Sugarbaker repair but experienced recurrence within six months. A subsequent open abdominal wall reconstruction was performed, including lipectomy, stoma relocation, and onlay reinforcement with a biosynthetic mesh, as dense intra-abdominal adhesions precluded retromuscular mesh placement. The postoperative course was uneventful, and no clinical or radiologic evidence of recurrence was observed at short-term follow-up of six weeks.

This case highlights the technical challenges associated with laparoscopic repair in recurrent PSH and demonstrates that open reconstruction with stoma relocation and onlay mesh reinforcement may be a feasible option in selected complex cases. However, given the limited duration of follow-up, long-term durability and recurrence rates cannot be assessed.