Operative Findings:
Large parastomal hernia with small bowel and omentum in it
No peritonial mets
No free fluid in pelvis
Operative Steps:
Position - supine
Painting with betadine
Draping with sterile towels
Pneumoperitonium created with varies needle at rt subcostal region
5 mm port inserted
Other two 5 mm port in the epigastric region and in rt lumber region
Hernia reduced, adhessions were seperated
Defect closed with transfascial sutures with prolene 2 0
sigmoid colon was retracted with the Hammock
5 mm rt subcostal port is converted to 12 mm
15 - 20 cm lotus provisc mesh inserted
Initially the corners of the mesh fixed with transfascial sutures
With the help of metal tackers double crown fixation of the mesh done
Haemostesis achieved
12 mm port sheath sutured
Skin sutured.