Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
200 participants
OBSERVATIONAL
2013-01-31
2024-08-31
Brief Summary
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Detailed Description
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All patients were classified preoperatively according to the European Hernia Society (EHS) classification. The procedure included laparoscopic adhesiolysis, open excision of the hernia sac, and laparoscopic intraperitoneal mesh fixation. A synthetic mesh (typically DynaMesh-IPST®) was used in most cases. In selected patients, a cost-effective alternative mesh was applied using a technique referred to as the "Baldachin modification," with an omental flap interposed to prevent adhesions.
The study included adult patients with symptomatic parastomal hernias who underwent elective surgery at a tertiary referral center for abdominal wall reconstruction. Exclusion criteria involved disseminated malignancy, contraindications to laparoscopy, and severely limited life expectancy. Patients were followed up in a dedicated outpatient setting with regular clinical and imaging assessments.
The aim of this study was to evaluate feasibility, safety, and the potential for broad implementation of the HyPER technique in the surgical treatment of parastomal hernias.
Conditions
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Study Design
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COHORT
RETROSPECTIVE
Study Groups
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HyPER Procedure
Combined laparoscopic and open surgical technique for parastomal hernia repair, including adhesiolysis, sac excision, mesh implantation, and stoma relocation if needed.
Hybrid Parastomal Endoscopic Repair (HyPER)
Combined laparoscopic and open surgical approach involving adhesiolysis, hernia sac excision, intraperitoneal mesh fixation, and stoma revision or relocation as indicated. Standard mesh used was DynaMesh-IPST®; in selected cases, a cost-effective modification with macroporous polypropylene mesh and omental interposition was applied.
Interventions
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Hybrid Parastomal Endoscopic Repair (HyPER)
Combined laparoscopic and open surgical approach involving adhesiolysis, hernia sac excision, intraperitoneal mesh fixation, and stoma revision or relocation as indicated. Standard mesh used was DynaMesh-IPST®; in selected cases, a cost-effective modification with macroporous polypropylene mesh and omental interposition was applied.
Eligibility Criteria
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Inclusion Criteria
* Symptomatic parastomal hernia requiring surgical intervention
* Eligibility for elective surgery
* Preoperative classification using the European Hernia Society (EHS) system
Exclusion Criteria
18 Years
ALL
No
Sponsors
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Medical University of Gdansk
OTHER
Swissmed Hospital
OTHER
Responsible Party
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Locations
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Bielański Hospital
Warsaw, , Poland
Countries
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References
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Szczepkowski M, Zamkowski M, Alicja S, Piotr W, Smietanski M. Evaluating EHS parastomal hernia classification for surgical planning: a retrospective analysis of 160 consecutive cases in a single center. Hernia. 2024 Oct;28(5):1915-1923. doi: 10.1007/s10029-024-03121-w. Epub 2024 Aug 10.
Szczepkowski M, Przywozka-Suwala A, Ziolkowski B, Witkowski P, Perea J. Hybrid parastomal hernia endoscopic repair (HyPER): novel approach to parastomal hernia surgery. Br J Surg. 2024 Apr 3;111(4):znae092. doi: 10.1093/bjs/znae092. No abstract available.
Szczepkowski M, Skoneczny P, Przywozka A, Czyzewski P, Bury K. New minimally invasive technique of parastomal hernia repair - methods and review. Wideochir Inne Tech Maloinwazyjne. 2015 Apr;10(1):1-7. doi: 10.5114/wiitm.2015.50052. Epub 2015 Apr 14.
Smietanski M, Szczepkowski M, Alexandre JA, Berger D, Bury K, Conze J, Hansson B, Janes A, Miserez M, Mandala V, Montgomery A, Morales Conde S, Muysoms F. European Hernia Society classification of parastomal hernias. Hernia. 2014 Feb;18(1):1-6. doi: 10.1007/s10029-013-1162-z. Epub 2013 Oct 1.
Antoniou SA, Agresta F, Garcia Alamino JM, Berger D, Berrevoet F, Brandsma HT, Bury K, Conze J, Cuccurullo D, Dietz UA, Fortelny RH, Frei-Lanter C, Hansson B, Helgstrand F, Hotouras A, Janes A, Kroese LF, Lambrecht JR, Kyle-Leinhase I, Lopez-Cano M, Maggiori L, Mandala V, Miserez M, Montgomery A, Morales-Conde S, Prudhomme M, Rautio T, Smart N, Smietanski M, Szczepkowski M, Stabilini C, Muysoms FE. European Hernia Society guidelines on prevention and treatment of parastomal hernias. Hernia. 2018 Feb;22(1):183-198. doi: 10.1007/s10029-017-1697-5. Epub 2017 Nov 13.
Other Identifiers
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HyPER-200
Identifier Type: -
Identifier Source: org_study_id
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