The topic is about the experiences and expectations of undergoing the Sugarbaker surgery for repairing a parastomal hernia. This is a second attempt for the person involved, as their first repair did not succeed due to complications. They are seeking advice on what to expect from this specific surgical technique.

Here are some insights and advice shared by others who have gone through similar experiences:

1. General experiences with Sugarbaker or laparoscopic mesh repair:
- One person shared that the first week involved intense pain, requiring strong pain relief.
- By weeks two and three, the pain had significantly improved, and they were able to stop taking narcotics, with mobility gradually increasing.
- They took about 5-6 weeks off work and returned to light duties.
- The stoma changed in size and shape, necessitating a new cutting pattern for appliances.
- Bowel irrigation resumed after three weeks and was easier without the hernia.
- They continued to wear a hernia belt, owning two to alternate while washing.

2. Decisions regarding mesh use:
- The modified Sugarbaker technique often involves placing an intraperitoneal mesh, considered a gold standard by many surgeons.
- Some surgeons avoid using mesh in contaminated fields or with immunosuppressed patients due to infection risks, opting for primary suture or stoma relocation instead.

3. Surgical approach options:
- Options include laparoscopic, robotic-assisted, or open procedures, depending on scar tissue and the surgeon's expertise.
- Botox injections into abdominal wall muscles are being trialed to help relax the wall, ease closure, and reduce recurrence.

4. Pain, recovery time, and activity limits:
- Many found that real recovery took closer to 6-12 months, rather than the often-quoted 6 weeks.
- Strict lifting limits of 5–10 pounds (2–4 kg) are recommended for at least 6–12 weeks, with long-term use of a support garment.
- Using a small pillow or folded towel to brace the abdomen when coughing, sneezing, standing, or during transport is advised.
- Avoid straining on the toilet and keep stools soft with hydration and stool softeners.
- Expect some coughing from anesthesia and have a splinting pillow ready.
- Fatigue and drowsiness are common, so rest and accept help when needed.

5. Hernia prevention and support garments:
- After surgery, wearing an abdominal binder or ostomy hernia belt with a pre-cut hole is recommended.
- Commercial belts can be costly, but DIY options include using a firm girdle or pregnancy-support garment and modifying it for the stoma.
- Long-term use of a hernia belt or back brace is advised, especially for those in physically demanding jobs.

6. Everyday self-care tips:
- Hold a pillow across the stoma when sneezing or coughing and support the abdomen when getting up.
- Keep loads close to the body and slide rather than lift when possible.
- Consider using a bedside rail, walker, or cane in the first weeks, which can be rented from agencies like the Canadian Red Cross.
- Stop aspirin or NSAIDs before surgery if advised by the surgeon, and prepare soft, low-residue foods for the postoperative period.

7. Weight and lifestyle factors:
- Rapid weight gain after surgery can increase intra-abdominal pressure and enlarge an existing hernia.
- Gentle core-strengthening exercises, once cleared by the surgeon, can help support the repair.

8. Recurrent or multiple hernias:
- Some people needed more than one hernia surgery, as recurrence risks remain even after Sugarbaker, especially if the original stoma site is still active.
- Some surgeons may relocate the stoma to the opposite side during repair, while others wait until reversal.

9. Special situations:
- Immunosuppressed patients face higher infection and wound-healing risks, so thorough risk-benefit counseling and possibly non-mesh repair are advised.
- In Canada, long wait-lists for elective hernia repair are common, so persistence and seeking second opinions are recommended.

10. Useful products and references:
- Golytely bowel prep is mentioned.
- Websites like the Washington Post and ACS Surgery News provide articles on the Sugarbaker procedure.
- Retail sources like Walmart and Amazon offer inexpensive girdles or pregnancy supports, and local Red Cross agencies rent equipment.