RT Book, Section A1 Ellison, E. Christopher A1 Zollinger, Jr., Robert M. A1 Pawlik, Timothy M. A1 Vaccaro, Patrick S. A1 Bitans, Marita A1 Baker, Anthony S. SR Print(0) ID 1187821578 T1 Parastomal Hernia Repair, Laparoscopic T2 Zollinger’s Atlas of Surgical Operations, 11e YR 2022 FD 2022 PB McGraw-Hill Education PP New York, NY SN 9781260440850 LK accesssurgery.mhmedical.com/content.aspx?aid=1187821578 RD 2024/03/29 AB Parastomal hernia is the most common late complication after stoma creation. In fact, given enough time, almost all stomas will develop some degree of herniation through the abdominal wall opening. In addition to the prevalent nature of parastomal hernias, attempts at repair are often followed by very high recurrence rates approaching 60%–70% in some series. Given this extraordinary risk of failure, the mere presence of a parastomal hernia should not be considered an indication for repair. Therefore, the initial approach should always include commonsense measures such as weight reduction and smoking cessation. A trial of a commercially available ostomy hernia belt, custom-fitted girdles, and other external support accessories is strongly encouraged. A consultation with a trained enterostomal therapy nurse plays an invaluable role during a trial of these nonoperative measures. Parastomal hernia repairs should only be offered to patients exhibiting significant pain or recurrent bowel obstructions and those who have failed a trial of external support devices. Another common indication for stoma repair is difficulty with maintaining a seal around the stoma and other pouching problems caused by the deformed abdominal wall. Of course, like a hernia at any other location, an incarcerated parastomal hernia constitutes an absolute indication for surgical intervention.