To investigate the procedure and the effectiveness of laparoscopic and open hybrid application of Sublay&Onlay-Keyhole in situ repair of parastomal hernia.

Between May 2017 and May 2019, 11 patients with parastomal hernia in the Fourth Medical Center of PLA General Hospital underwent laparoscopic and open hybrid application of Sublay&Onlay-Keyhole technique in situ repair. All stomas of patients were permanent, including 8 cases with end colostomies following Miles operation for low rectal cancer, and 3 cases with end ileostomies following ileal conduit for bladder cancer. Two patients had recurrence after previous parastomal hernia repair. The average time from last operation was 3.75 years (range, 3.5 to 4.0 years). The average longest diameter of hernia ring was 5.55 cm (range, 4 to 8 cm).

Reconstructions of abdominal wall in all 11 patients were performed successfully through laparoscopic and open hybrid application of Sublay&Onlay-Keyhole technique. The average operative time was 141.55 minutes (range, 110 to 190 minutes) and the average postoperative hospitalization days were 10 days (range, 6 to 18 days). All patients achieved healing of incision by first intention with no intestinal fistula or abdominal wall infection. Seroma occurred in 2 patients (18.2%). All patients were followed up 14.55 months on average (range, 6 to 23 months). No parastomal hernia recurrence or incisional hernia occurred in the 11 patients.

Laparoscopic and open hybrid application of Sublay&Onlay-Keyhole in situ repair of parastomal hernia is an effective procedure for reconstruction of abdominal wall, which has the advantages of low recurrence rate and less complications. But the long-term effectiveness needs further observation and follow-up.