Parastomal hernia describes a hernia beside a stoma, which may be clinically diagnosed by palpating a bulge adjacent to the stoma and confirmed by CT scan, which demonstrates intraabdominal contents protruding along an ostomy (1).

The rate of Parastomal hernia has been reported to range between 5–52%. The great variance reported has been attributed to the utilization of different definitions of hernia and a wide range of follow-up criteria for patients (2,3,4).

Once the patient has completed an appropriate preoperative medical clearance, consideration should be given to a standard bowel preparation. Although recent literature has suggested that standard bowel prep is not mandatory, it is the author’s preference as the cleansed colon is technically easier to manipulate when it does not have a significant
fecal load. For those patients who can tolerate an oral preparation, an iso-osmotic lavage prep is suggested (polyethylene glycol solution). An appropriate broad-spectrum antibiotic should be administered intravenously, within 1 hour prior to the initial incision. As with other abdominal operations, routine venous thrombosis prophylaxis is utilized. The consent form should include information concerning the utilization of prosthetic materials in the management of the repair, as well as a clear discussion of alternatives, and reasonable clinical expectations.

After adequate general anesthesia has been obtained, the patient is placed in the lithotomy or supine position with the extremities appropriately padded. The utilization of an oral gastric tube and urinary bladder catheter are routine. The patient may need some rotational adjustment to provide the best exposure to the ostomy site.