Laparoscopic stoma formation with a prophylactic prosthetic mesh        Janson AR*, Jänes A, Israelsson LA. *Department of Surgery, Kirurgkliniken, Sundsvalls sjukhus,851 86 Sundsvall, Sweden
Corresponding author: Janson AR, E-mail: alfred.janson@lvn.se
Abstract    objective    One year after stoma formation with an open technique, the rate of parastomal hernia is almost 50%. The herniation rate can be reduced to 10% with the use of a prophylactic mesh in a sublay position. For stomas formed with a laparoscopic technique, a surgical method with the use of prophylactic mesh should be sought. Methods    Patients with a sigmoidostomy created with a laparoscopic technique were provided with a prophylactic large-pore, low-weight mesh in a sublay position. Followup examination was carried out after at least 12 months. Results    Between March 2003 and May 2007, a sigmoidostomy was created in 25 patients. The patients’ mean age was 65 years (range 31-89), the mean body mass index was 26 (range 21-32) and 15 were female. One stoma necrosis and two minor wound infections occurred. Parastomal hernia was present in 3 of 20 patients (15%) available for follow-up examination after 11-31 months (mean 19). No fistulas or strictures had developed. No mesh infection was noted and no mesh was removed. Conclusion   In laparoscopic stoma formation, a prophylactic large-pore, low-weight mesh in a sublay position is an easy and safe procedure associated with a low rate of parastomal hernia.