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May 16, 2012

Recurring hernias around stoma site - seeking advice on surgery

This topic is about dealing with recurring parastomal hernias and considering stoma relocation surgery. The person sharing their experience has a stoma that helps manage Crohn’s disease but has faced challenges with large hernias forming around it. Despite three previous hernia repairs, new bulges keep appearing. They are scheduled for another surgery to move the stoma to the other side of the abdomen and repair the current hernia. They are concerned about the possibility of hernias forming again and are seeking advice from others who have undergone stoma relocation.

Here are some insights and advice shared by others:

1. Successful site change: Many people have found that after multiple failed repairs, moving the stoma to a new location resolved their hernia issues.

2. When not to move the stoma: If someone has had many abdominal surgeries, surgeons might avoid creating a new stoma to prevent further shortening of the intestine, which can lead to dehydration and absorption problems. In such cases, they may try to repair the hernia at the original site.

3. Surgical details to discuss:
- Consider asking the surgeon to remove any excess fatty tissue or loose skin left by the hernia, as it can affect how well the flange adheres and make the abdomen uneven.
- A typical hospital stay after surgery is reported to be between 4½ to 7 days if everything goes smoothly.
- It's possible to repair multiple hernias in one operation, as some have experienced.

4. Deciding whether to have a repair: Some choose surgery due to frequent appliance leaks, difficulty dressing, visible bulging, and emotional distress. Others manage with large, painless hernias as long as their wafers stay secure.

5. Risk factors and prevention tips: Heavy lifting, abdominal trauma, and even a violent sneeze can trigger hernias. After repair, it's important to limit lifting and protect the abdominal wall.

6. Smoking and eligibility: Some surgeons may not perform elective hernia repair if the patient smokes, so quitting smoking might make surgery an option again.

7. Day-to-day management if you keep the hernia:
- Consider clothing options like elastic-waist skirts or pants, as jeans with fixed waistbands can be difficult.
- Keep an eye on appliance adhesion and consider repair if the bulge causes repeated leaks.

8. General encouragement: Many people emphasize that successful outcomes are possible whether you relocate the stoma or repair it in place, and they offer their best wishes for the upcoming surgery.
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