Parastomal Hernia (PSH) Repair at Mayo Clinic: Helping Patients Live their Life.

Many times people have been dealing with or struggling with issues around their parastomal hernia for a longtime in isolation. And our real goal is to address that isolation and give you hope that we can fix that problem. Having an ostomy can really truly affect your life. I want patients to know that this is a special place. You know? Yes, we do lots of surgeries. We see a lot of patients, but we treat you as an individual. We want to make your life better. We're here to listen to whatever you want to talk to us about. The surgeons will take the time to listen to your story, what you've been going through, and they will be honest with you as what they can and cannot do for you. That's really the way our team approaches it, is more than just fixing the hernia. A parastomal hernia is an enlarged defect in the abdominal wall. And what happens are things that aren't supposed to be there, go through it like you're small intestine and that can cause a problem for patients. Challenges related to parastomal hernia vary from patient to patient. If it's affecting that patient, if it can impact their quality of life in their work environment, their home environment, their relationship, or just their feeling of self. Doing a repair basically restores their normal anatomy. As far as appearance, some may require surgery, some we can address with less invasive approaches. And that's why we really need a team of experts to address these problems.

There are certain indications that we really deem as needing to be considered seriously for repair. Some of these are life threatening issues such as obstruction associated with the hernia. Parastomal hernia repairs is not something that's routinely done in the local community. Many patients had a stoma constructed at home because of an emergency situation or because the patient was very ill, and that was the appropriate treatment at the time. Sometimes we can reverse the stoma and repair the hernia. We have a vast experience seeing these patients and operating on them. Where most institutions maybe do just a handful of robotic parastomal hernia repairs. Just in the last two years, we've done over 100. The robotic approach to parastomal hernias has transformed the practice for me. And then combining that with a Sugarbaker approach has been considered the gold standard for the lowest level of recurrence. And what this does is places a large sheet of mesh inside the abdomen to prevent any type of defect that would allow another hernia to form. Robotic surgery is really about translating what I would do in an open procedure with my hands into machine capabilities with very small instrumentation. And I can tell you that patients really are impressed with the fact that it's all done with four half inch incisions and no big scars. Those techniques are perfected by the more you do. With the robotic parastomal hernia repair, they don't have to stay in Rochester as long. Typical stay is about two to three days. Not only are we good at the surgical technique with these parastomal hernia repairs, but we have a large ostomy team here of seventeen nurses that are dedicated just to caring for ostomy patients.

We're trying to take as many things into consideration as possible, so you know what you do for your profession. Types of clothing that you wear, what you like to do for fun. What about times of intimacy? We see thousands of patients a year, so maybe a patient has given us a tip that we can share with another patient. And there's a variety of pouching systems that patients don't even, they're not aware of. I want them to be comfortable with what they're doing. That's really the goal is not just to fix the hernia, but to fix the whole situation around having an ostomy that may not be functioning normally for you. It's about the whole person. So whatever they're dealing with, we want to help them with that so that they can improve their quality of life and go live it.