Laparoscopic prosthetic parastomal and perineal hernia repair after abdominoperineal resection

In a patient presenting both Parastomal hernia (PSH) and Perineal hernia (PH), simultaneous open abdominal repair requires a quite large incision to get access to the abdomen as well as to the pelvis. Another option is to separate the open abdominal access for PSH from the open perineal approach for the PH. On the other hand, abdominal laparoscopy offers a good solution because both repairs can be performed using the same trocars disposition. Moreover, laparoscopic repair can add the known advantages of minimally invasive surgery like shorter hospital stay, reduced wound infection rate, improved patient comfort, and better cosmetic results. The authors report a 74-years-old female, with a 30.3 kg/m2 body mass index, with episodes of intestinal occlusions following a procedure of open Abdominoperineal resection (APR), performed 6 years before for rectal adenocarcinoma (pT2N0M0). Preoperative work-up, including positron emission tomography (PET)–computed tomography (CT), was negative for tumor recurrence. Abdominopelvic CT scan showed a PSH with migrated bowel loops and a PH with transposition of the cecum and small bowel loops into the pelvis (Fig. 1). A laparoscopic treatment by double dual-face prosthesis was proposed and showed in the correspondent video.