Single-center experience with mesh suture for primary parastomal hernia repair

INTRODUCTION: Parastomal hernias remain a persistent challenge for hernia surgeons due to significant wound morbidity and high rates of hernia recurrence. Enlarging of the stomal aperture due to suture pull-through or de novo fascial separation can lead to recurrence despite repair technique. Mesh suture (Duramesh, Mesh Suture Inc, Chicago, IL) is designed to distribute tension across multiple filaments, theoretically reducing pull-through. We analyzed our outcomes of the use of Duramesh as an alternative to primary suture closure in the repair of primary and recurrent parastomal hernias. METHODS: We conducted a single-center, retrospective review of a prospectively maintained series of patients who underwent primary repair of parastomal hernias using Duramesh between January 2024 and July 2025. We included both primary and recurrent parastomal hernias with no exclusion based on prior repair type or defect size. RESULTS: ). Mean operative time was 225 min and mean length of stay was 6.4 days. Surgical site occurrences were identified in 26.2% of patients, including a 7.1% SSI rate. At a mean follow-up of 7.1 months, 54.8% of patients developed hernia recurrence, with a mean time to recurrence of 6.4 months. Patients undergoing redo parastomal hernia repair had significantly higher recurrence rates compared to those undergoing first time repair (61.5% vs 30.8%, p = 0.050). CONCLUSIONS: Primary PSH repair with Duramesh alone is associated with high recurrence rates (54.8%) and should not be considered a durable standalone strategy. Though suture pull-through was not identified as a failure mechanism in this limited series, the persistent stomal aperture renders primary repair insufficient regardless of suture construct.