Feasibility of Hybrid Double-Layered Mesh Repair for Parastomal Hernia: Laparoscopic Intraperitoneal Underlay Combined with Gasless Laparoscopic Subcutaneous Anterior Fascial Overlay.

This hybrid technique achieves anatomical separation of the two mesh layers-distinguishing it from the conventional sandwich technique-and demonstrates promising early outcomes with zero recurrence and zero mesh infection.

The approach represents a feasible and potentially durable option for parastomal hernia repair, though prospective multicenter studies with longer follow-up are warranted.