Surreal illustration of parastomal hernia surgery with glowing blue mesh.

Parastomal Hernia Repair: Is There a Minimally Invasive Solution?

Rhea Morgan in Health & Wellness July 2025 • 4 min read.

"A new hybrid approach offers hope for fewer complications and better satisfaction after parastomal hernia repair."

If you've had ostomy surgery, you might be familiar with a common complication: the parastomal hernia. These hernias occur when abdominal contents protrude through the opening in the abdominal wall created for the stoma. While surgical repair is often the answer, finding the best approach can be tricky.

Traditional surgical methods range from simple fascial repair to stoma relocation, often involving mesh. But these approaches have drawbacks, including high recurrence rates and other complications. This has led researchers to explore new, less invasive techniques that can offer better outcomes.

Now, a new technique called HyPER/SPHR (hybrid parastomal endoscopic re-do/Szczepkowski parastomal hernia repair) is showing promise. This article will explore the HyPER technique, examining its methods and early results to help you understand if it could be a viable option for parastomal hernia repair.

The HyPER Technique: A Minimally Invasive Hybrid Approach

Surreal illustration of parastomal hernia surgery with glowing blue mesh.

The HyPER technique combines laparoscopic (minimally invasive) and open surgical methods in a unique four-step process:

Here's a breakdown of what each stage entails:

Laparoscopic Stage: The surgeon makes small incisions and uses a camera and specialized instruments to visualize the hernia and surrounding tissues. They'll then perform adhesiolysis, freeing the stoma bowel from any internal adhesions.
Open Stage: While maintaining abdominal pressure, a circular incision is made around the stoma to access the hernia gate. The surgeon then closes the end of the ostomy bowel and prepares the subcutaneous tissue. The hernia sac is carefully dissected and removed.
Re-conversion to Laparoscopic Approach: A special mesh (DynaMesh-IPST) is placed through the hernia gate and secured to the abdominal wall using laparoscopic instruments and ProTacks™ tacks. The hernia orifice is narrowed to the appropriate size.
Final, Open Stage with Neo-Stoma Formation: After removing the laparoscopic instruments, the surgeon closes the trocar openings, places drains, and creates a new, matured stoma.

This hybrid approach aims to achieve several key benefits: complete removal of the hernia sac, proper stoma canal creation, and secure mesh placement, all while minimizing the invasiveness of the surgery.

The Future of Parastomal Hernia Repair

The HyPER procedure offers a promising new avenue for treating parastomal hernias. Its hybrid approach combines the benefits of minimally invasive techniques with the precision of open surgery, potentially leading to fewer complications and improved patient satisfaction.

While the early results are encouraging, further research is crucial. Larger, randomized controlled trials with longer follow-up periods will help to definitively determine the HyPER technique's long-term efficacy and compare it to other established methods. Key factors to watch include recurrence rates, complication rates, and overall quality of life for patients.

If you're considering parastomal hernia repair, discuss all available options with your surgeon. The HyPER technique may be a suitable choice, especially if you're looking for a minimally invasive approach with the potential for lasting results. As research continues, we can expect even more refined and effective solutions for this common post-ostomy complication.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

Everything You Need To Know

What exactly is a parastomal hernia, and how does the HyPER/SPHR technique address it differently than traditional surgical methods?

A parastomal hernia happens when abdominal contents push through the abdominal wall opening created during ostomy surgery for the stoma. Surgical repair is frequently needed, but the HyPER/SPHR technique (hybrid parastomal endoscopic re-do/Szczepkowski parastomal hernia repair) offers a potentially less invasive solution compared to traditional methods. Traditional approaches, from simple fascial repair to stoma relocation with mesh, can have high recurrence rates and other complications. The HyPER technique seeks to minimize these issues.

Can you break down the HyPER technique step-by-step? What are the key components of this hybrid approach for parastomal hernia repair?

The HyPER technique combines laparoscopic and open surgical methods in four steps: laparoscopic adhesiolysis, open hernia sac dissection and removal, laparoscopic mesh (DynaMesh-IPST) placement with ProTacks™ tacks, and open neo-stoma formation. This hybrid approach aims to remove the hernia sac completely, create a proper stoma canal, and securely place mesh, all while minimizing surgical invasiveness.

During the HyPER procedure, how do the laparoscopic and open stages work together? What happens in each phase, and why is this combination important?

The HyPER technique involves both laparoscopic and open surgical stages. First, laparoscopically, the surgeon frees the stoma bowel from adhesions. Then, through an open incision, they remove the hernia sac and prepare the tissue. The approach then reverts to laparoscopic for mesh placement (DynaMesh-IPST secured with ProTacks™ tacks). Finally, the instruments are removed, and a new stoma is created through an open procedure.

What are the potential benefits of the HyPER procedure compared to traditional parastomal hernia repair techniques? How might it lead to fewer complications and greater patient satisfaction?

The HyPER procedure aims to reduce complications and improve patient satisfaction through a combination of minimally invasive and open surgical techniques. The complete removal of the hernia sac, secure mesh placement using DynaMesh-IPST and ProTacks™ tacks, and careful stoma canal creation contribute to potentially better outcomes than traditional methods. The approach seeks to minimize invasiveness while maximizing the effectiveness of the repair.

What additional information or research is needed to fully evaluate the HyPER technique and its long-term effectiveness for parastomal hernia repair?

While the HyPER technique represents a promising development, more information is needed regarding long-term outcomes, comparative studies against other methods, and its applicability across diverse patient populations. Details regarding specific success rates, comprehensive complication profiles, and comparative cost-effectiveness data would provide a more complete understanding of the technique's value. Further investigation of factors influencing patient selection and optimization of the surgical protocol would also be beneficial.