To systematic explore the technical feasibility and details of lap-endoscopic sublay/ trans-abdominal preperitoneal patch repair (TES/TAPP) for parastomal hernia.

Six parastomal hernia patients were enrolled in He Xian Memorial Hospital Affiliated to Southern Medical University, Fengxin County Traditional Chinese Medicine Hospital, Jinhua Central Hospital, Huizhou Sixth People's Hospital, Xianyang First People's Hospital and Pingba District People's Hospital of Anshun City from December 2020 to October 2021. Patients' demographics and perioperative details were retrospectively collected and analyzed. The association of original surgical method and current hernia repair method was analyzed. The operation details were recorded and experiences were summarized.

Four patients were performed by TES mesh repair. Among them, the meshes were deployed with Sugarbaker configuration in 3 patients and Keyhole pattern in 1 patient. Two patients were operated by TAPP repair in a Sugarbaker configuration. The mean mesh size used was (246.0±26.0) cm². The mean operative time was (220.0±29.0) min. The blood loss was minimum. All operations were successful without vascular or visceral damage or conversion. Two patients underwent stoma reconstruction. The postoperative pain was minimum. The mean pain visual analogue score at rest on day 1 was (3.3±0.8) points. The average stoma exhaust time was (2.6±0.5) days. The average postoperative stay was (8.0±2.8) days. All patients were followed for 3 to 10 months. Patients were satisfied with postoperative stoma and abdominal wall appearance. There was no recurrence, no postoperative chronic pain, no mesh infection. One patient with stoma reconstruction developed a stomal wound infection, and she was cured after drain replacement and wound debridement.

The TES/TAPP techniques for parastomal hernia repair are safe and technically feasible. The indication for these techniques is limited so the true efficacy remain to be explored. Owing to the technically challenging property, these techniques are destined to be the armamentarium of few skilled hands.