Robot-Assisted Pauli’s Parastomal Hernia Repair After Failed Sugarbaker Repair

Introduction: Parastomal hernia is the most common long-term complication after stoma creation, with an estimated incidence of 5%−60%.1 Parastomal hernias can be a source of chronic pain and discomfort, as well as impaired quality of life from issues with stoma function and ostomy appliance application.2 Small bowel obstruction and strangulation necessitating emergent surgical intervention can also result.3 Several surgical options have been described for the repair of parastomal hernias, with the most common being keyhole and Sugarbaker repair. Pauli’s repair, first described in 2016 by Eric Pauli, is a modified Sugarbaker parastomal hernia repair that utilizes the retrorectus space to lateralize the bowel and place a mesh in a sublay fashion.4