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Combined perineal hernia repair and abdominal parastomal hernia with mesh for sequela of an abdominoperineal resection

Clinically, significant perineal hernias are rare, occurring in <1% of all hernias. They may be congenital but are most commonly acquired and secondary to abdominoperineal resection (APR) or pelvic exenteration as treatments for cancer. We report a novel case of a combined perineal hernia and abdominal parastomal hernia and our approach for repair with mesh. The perineal hernia repair utilized a composite mesh implant, which was anchored to Cooper's ligament and the anterior longitudinal ligament. The parastomal hernia required component separation and re-siting of the stoma. This case describes a unique method for repairing the uncommon sequelae of concurrent perineal and parastomal hernias after an APR for rectal cancer.