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Abstract
A CASE OF PARASTOMAL HERNIA REPAIRED
BY THE SANDWICH PLUS METHOD
Sayaka ARISAKA Masayuki NAKASHIMA Mitsutaka SUGITA
Department of Surgery Yokohama City Minato Red Cross Hospital
A case of parastomal hernia in a patient after total cystectomy and ileal conduit construction for bladder cancer is
reported. An 81-year-old man found a bulge around the stoma and was diagnosed with a para-stomal hernia 22
months after surgery. Because attachment of the stoma pouch became difficult, it was decided to repair the parastomal
hernia. On adhesiolysis, a 3×5-cm2 hernial orifice was seen. The orifice was closed with four 2-0 absorbable thread
sutures and repaired with the sandwich plus method (a combination of the keyhole method and the Sugarbaker
method). The patient has not had any postoperative complications, and there has been no recurrence for 4 years after
discharge. There have been few reports of laparoscopic parastomal repair in Japan. Although it is necessary to
evaluate more cases and consider the best treatment method, the Sandwich plus method appears to be an acceptable
option.
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