If the clinical experience is very important for everyday practice…

Prof. Marek Szczepkowski is the head of the Department of General and Colorectal Surgery of Bielański Hospital in Warsaw, one of the most experienced surgical departments in parastomal hernia repair in Poland.
Several surgical techniques of parastomal hernia repair have been described. Currently, the Sugarbaker technique, described in 1980, and the sandwich technique, which was first described by Berger, are the most common for surgical repair [1, 2]. The laparoscopic approach to parastomal hernia repair seems to be superior to the open approach due to its lower rate of recurrence and lower rate of postoperative complications, and this method was suggested by Hansson et al. [3]. Laparoscopy in other hernia repair regions has been advocated for many times by numerous surgeons, including in the pages of Videosurgery, and it was extremely encouraging that the Hybrid Operation was used by a team of Prof. Szczepkowski in parastomal hernia repair [4, 5].
Polish surgeons’ contribution to the development of this very difficult field of hernia repair surgery is very visible. The classification currently in force and suggested by the European Hernia Society (EHS) takes into account the experience of the center which is headed by Prof. Szczepkowski [6, 7]. From this center there have been published several papers concerning the experience of Bielański Hospital. During the consensus meeting on Parastomal Hernia Repair in Gdansk in 2011, the Working Group of Polish specialists in this domain was established. The goal of this group was to give a recommendation and the proper approach to this surgical problem, which is very difficult to resolve. This consensus was published in the Polish Journal of Surgery as a contribution to further discussion and studies and is still the indicator for many surgeons [8].
This original paper presents a prospective single center and single surgeon study which shows early results of the novel concept of the minimally invasive surgical technique of parastomal hernia repair – the HyPER technique (Hybrid Parastomal Endoscopic Re-do). It also contains a short review of the most popular methods of resolving this difficult surgical problem.
This technique consists of three main parts: the initial, laparoscopic part (adhesiolysis of the region of the ostomy and hernia sac; the next part – open technique (excision of stoma and hernia sac, intraperitoneal placement of special, dedicated for parastomal hernia...


View full text...