To summarize the optimization strategies for the surgical details of laparoscopic Sugarbaker repair in the treatment of parastomal hernia, and to investigate the perioperative outcomes and short-term follow-up results of the modified technique.

This study is a single-center retrospective case series study. We selected 24 patients with parastomal hernia who were treated with totally laparoscopic modified Sugarbaker repair in the Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, from January 2024 to December 2025. Clinical data were collected, including baseline characteristics, perioperative parameters (operative time, intraoperative blood loss, time to first flatus and defecation, length of postoperative hospital stay, etc.), stoma defecation function scores, postoperative complications, and follow-up outcomes, in order to assess surgical safety, postoperative efficacy, and hernia recurrence.

All 24 patients successfully completed modified repair without conversion to open surgery. The mean age was (69.08±8.31) years, with 12 males and 12 females. Perioperative indicators were expressed as median (interquartile range, Q₁, Q₃): operative time 118 (97.75, 127.25) minutes, intraoperative blood loss 20 (10.0, 32.5) ml, time to first flatus 1 (1, 2) days, time to first defecation 3 (2, 3) days, and postoperative hospital stay 5 (4, 5) days. No severe postoperative complications such as bowel perforation, intestinal obstruction, mesh infection, or stomal ischemia and necrosis were observed. Postoperative stoma defecation function scores indicated that most patients had generally favorable outcomes in defecation awareness, continence, and sensory function. During a follow-up of 3-24 months (median, 13 months), no parastomal hernia recurrence was detected. In addition, most patients showed significant improvement in abdominal wall appearance, stoma comfort, and physical activity.

With optimization of key surgical details, laparoscopic Sugarbaker repair for parastomal hernia appears safe and feasible, with rapid postoperative recovery and no recurrence observed in the short-term follow-up. However, this was a single-center retrospective study with a small sample size and limited follow-up duration; further studies are needed to validate these findings.