The topic at hand is about considering surgery for a large parastomal hernia, which has developed after a colostomy. The person is dealing with a hernia about the size of a cantaloupe, causing pain, poor drainage, frequent blockages, and difficulty concealing it under clothing. They are contemplating surgical repair but are concerned about potential complications.

Here are some insights and advice shared by others:

1. The hernia is causing significant issues such as obstruction, pain, and appliance failure. Some people have found that surgery, whether open or laparoscopic, can relieve these problems and help restore normal life.
- One person had an open repair for an ileostomy-related hernia and fully recovered.
- Another had laparoscopic repairs and has been symptom-free for several years.

2. Minimally invasive (laparoscopic) repair is an option, though not many surgeons perform it. A recommended surgeon in Toronto is Dr. John Hagen from the Minimally Invasive Surgery group.

3. Surgeons often wait to repair a hernia unless it affects bowel function or appliance wear, as hernias can recur even after mesh reinforcement. This is especially common in older patients.

4. Some doctors consider a bulge to be "normal" and note it can provide a flat base for the flange. Cosmetic concerns alone might not be enough to justify surgery.

5. For non-surgical management of large hernias or prolapsed stomas, consider:
- Using Hollister 8531 drainable colostomy bags with a custom-cut 2-inch oval wafer.
- Applying Hollister Adapt Lubricating Deodorant at each change, and switching to Johnson & Johnson Baby Oil for routine draining to save on costs.
- Cleaning the prolapsed stoma in the shower with a microfiber cloth, then lying down and gently pressing with VIVA paper towels to help it retract.
- Using convex rings and flanges to improve the seal, but be cautious as excessive pressure can create new hernias.

6. It's wise to seek second opinions. Dr. Philip Kondylis in Suffolk, VA, was mentioned as being candid and helpful.

7. A member from South Africa is exploring the laparoscopic mesh "Sugarbaker" technique for hernia repair and is looking for feedback on its success rates.