Laparoscopic parastomal hernia repair can be technically challenging. We herein present a simplified technique of laparoscopic parastomal hernia repair.

Exploratory laparoscopy is performed, adhesions are lysed, and the hernia defect is measured. An appropriate size of Dual mesh plus is chosen. A cruciate incision is created at the middle of the mesh to host the colostomy and is connected to one side of the mesh. A non-absorpable suture is placed at each corner of the mesh. The mesh is then rolled tightly from each side to the middle and vicryl stay sutures are used to keep the mesh rolled. Once inside the abdominal cavity, the rolled mesh is then fixed to the abdominal wall so it bisects the hernia defect. The superior half of the mesh is unfolded and fixed circumferentially using a combination of sutures and tacks. The same is repeated to the lower portions of the mesh. The gap between the colostomy loop and the mesh is closed using non-absorbable sutures.

This alternative technique of laparoscopic mesh placement, minimizes intracorporeal mesh manipulation, and provides an adequate coverage to the hernia defect while hosting the colostomy without restriction.