-Case Report-

Small Intestinal Adhesion at a Parastomal Hernia of the Ileal Conduit and Hernia Repair with Laparoscopy and Tailored Mesh: A Case Report

Shin Imura¹, Yusuke Ogi¹, Kei Ishimaru², Shigehiro Koga¹, Motohira Yoshida¹, Satoshi Akita², Satoshi Kikuchi¹, Hiroki Sugishita¹, Jun Kuwabara¹, Hironori Matsumoto¹, Kai Goyo¹ and Taro Oshikiri¹

¹Department of Gastrointestinal Surgery and Surgical Oncology, Ehime University Graduate School of Medicine, Ehime, Japan
²Department of Minimally Invasive Gastroenterology, Ehime University Graduate School of Medicine, Ehime, Japan

Parastomal hernia of the ileal conduit (PHIC) is a long-term complication of radical cystectomy (RC) for bladder cancer. A systematic review reported an estimated incidence of PHIC after RC of 17%. Several surgical techniques have been reported for treating parastomal hernias. However, few studies have investigated treatment of PHIC, and there are no guidelines for the optimal approach for PHIC repair. Here, we describe a case in which good results were achieved using the laparoscopic Sugarbaker (LS) technique with a tailored mesh for PHIC. An 80-year-old Japanese woman underwent robot-assisted radical cystectomy for bladder cancer. Ten months after surgery, she was diagnosed as having bowel obstruction due to PHIC. The LS technique was performed using a tailored mesh. Severe small-intestinal adhesions from previous surgeries were safely divided using laparoscopic surgery. No hernia recurrence was observed at 2 years postoperatively. We used the LS technique to treat PHIC, and severe small-intestinal adhesions were safely treated using laparoscopic surgery. The LS technique appears to be a viable therapeutic option for such cases.

J Nippon Med Sch 2026; 93: 279-283

Keywords
parastomal hernia, urinary diversion, surgical mesh, laparoscopy

Correspondence to
Taro Oshikiri
urotarikishio@gmail.com

Received, July 9, 2024
Accepted, February 21, 2025