Parastomal Hernia Repair
Surgical Technique Guide
Parastomal Hernia Repair
Surgical Technique Guide
1. The techniques presented herein are for informational purposes only. The decision
of which technique to use in a particular surgical application lies with the physician
based on patient profile, particular circumstances surrounding the repair and
previous surgical experiences.
2. Please refer to the Instructions for Use included with the applicable MatriStem
Surgical Matrix device for indications, contraindications, cautions, warnings,
precautions, potential complications and other important information about
MatriStem Surgical Devices.
1
KEYHOLE Technique
1. INCISION AND
DISSECTION:
The hernia sac is identified and
sharply dissected free from the
bowel and stoma tunnel. The
hernia is fully reduced.
2.PRIMARY CLOSURE:
After the sac has been removed
from the stoma ring, the
defect is primarily closed,
re-establishing desired stoma
anatomy.
2
3.INITIAL SECURING OF THE
GRAFT: (Keyhole)
The graft is secured with sutures or tacks
on one side of the stoma ring and then
wrapped around the bowel exiting the
stoma tunnel. Care is taken to assure the
graft is not too tight, which could lead to
obstruction, or too loose, which could
lead to hernia recurrence.
Note: Hydrate MatriStem® Surgical Matrix
Plus* in sterile saline solution for at least 20
minutes prior to placement in surgical site.
Note: Place the textured tunica propria side
beside/toward the abdominal wall.
* Example of a MatriStem Surgical Matrix device that may be appropriate for the procedure.
4.FINAL SECURING OF THE
GRAFT: (Keyhole)
The graft is secured circumferentially
using sutures or tacks.
Note: The graft should extend at least 5 cm
past the edge of the closed defect.
3
SUGARBAKER Technique
1. INCISION AND
DISSECTION:
The hernia sac is identified and
sharply dissected free from the
bowel and stoma tunnel. The
hernia is fully reduced.
2.PRIMARY CLOSURE:
After the sac has been removed
from the stoma ring, the
defect is primarily closed,
re-establishing desired stoma
anatomy.
4
3.INITIAL SECURING OF THE
GRAFT: (Sugarbaker)
The graft is secured on anterior side of
the ostomy, and pulled taut, assuring
complete coverage of the stoma ring.
Note: Hydrate MatriStem® Surgical Matrix
Plus* in sterile saline solution for at least 20
minutes prior to placement in surgical site.
Note: Place the textured tunica propria side
beside/toward the abdominal wall.
* Example of a MatriStem Surgical Matrix device that may be appropriate for the procedure.
4.FINAL SECURING OF THE
GRAFT: (Sugarbaker)
The graft then tacked into place on the
lateral sides. The posterior side is left
free, and the bowel drapes over the free
edge as it returns to the abdominal cavity.
Note: The graft should extend at least 5 cm
past the edge of the closed defect.
5
About MatriStem Surgical Matrix Devices
MatriStem® Surgical Matrix devices are biologically-derived devices comprised of porcine Urinary
Bladder Matrix (UBM), a patented, proprietary technology of ACell, Inc. The MatriStem Surgical
Matrix maintains an intact epithelial basement membrane, and facilitates the body’s ability to
form site-specific tissue at the site of the defect. The product will resorb over time, leaving behind
constructively remodeled tissue to continue supporting the patient’s anatomy.
ACell, Inc.
6640 Eli Whitney Drive
Columbia, MD 21046
www.acell.com
800-826-2926
All Illustrations © 2015 Timothy Phelps.
MK-0150.1 07/2015