Open Parastomal Hernia Repair with KeyBaker Mesh Placement Technique

1. Introduction

2. Incision and Exposure

3. Reduction of Hernia and Mobilization of Colon

4. Ipsilateral Retrorectus Dissection

5. Transversus Abdominis Release (TAR)

6. Connecting the Retrorectus Planes Around the Stoma

7. VY Advancement Flap in the Posterior Sheath and Peritoneum

8. TAP Block

9. Final Stomal Adjustments

10. Contralateral Retrorectus Dissection

11. Superior Dissection and Preparation for Mesh

12. TAP Block

13. Posterior Rectus Sheath Closure

14. KeyBaker Mesh Placement: Modified Sugarbaker and Keyhole Techniques

15. Drain Placement Through Contralateral Side

16. Anterior Rectus Sheath Closure

17. Closure

18. Post-op Remarks