Posters

Welcome to the AHS 2020 ePoster Session. Please scroll down to view all of the submitted posters or press Control-F to search. To view the poster and its abstract, click on the poster image. Many posters also have a brief audio introduction which can be played by going to the bottom of the poster screen.

P070: ROBOTIC PARASTOMAL HERNIA REPAIR
Dillon Isaac; Jeremy A Warren, MD, FACS; Michael W Love, MD; University of South Carolina School of Medicine Greenville

Introduction: Parastomal hernias can be a complex problem requiring a multidisciplinary approach. We present a series of parastomal hernia repairs performed via a robotic approach. 

Methods: Analysis of a prospective hernia registry (AHSQC) for our institutional cases of robotic parastomal hernia repair.  Surgical technique and clinical outcomes, including complications, surgical site infection (SSI), surgical site occurrence (SSO), and hernia recurrence are reported.

Results: Of 21 patients (12 male and 9 female), comorbidities included 11 with hypertension, 4 diabetics, 6 patients with COPD, 3 with Chron’s disease, and 4 patients with indwelling prior mesh. All procedures were elective, with the most common indication being pain, with the most common ASA class being 3. Of robotic approaches, 5 were performed in an IPOM sugarbaker fashion, 2 were performed via transabdominal retromuscular approach, and 12 extended totally extraperitoneal approach using keyhole mesh (or flat mesh if ostomy was taken down), and 2 were repaired primarily. Twelve patients require transversus abdominis release to complete the repair (10 unilateral, 2 bilateral). One patient required conversion to open. IPOM surgarbaker repair was performed using dual layer biologic tissue scaffold/PTFE mesh, all other mesh repair were performed using wide pore polypropylene mesh. There were 2 superficial surgical site infections requiring PO antibiotics, 6 surgical site occurrences (3 seroma, 1 hematoma, 2 cellulitis), and only one seroma requiring percutaneous drainage. There were no recurrences at an average follow up of 170 days. 

Conclusion: Robotic parastomal hernia repair is feasible and affords the ability to perform more complex extraperitoneal mesh repairs previously only possible with open surgery.  

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