Funnelmesh and modified keyhole techniques show superior outcomes for parastomal hernia repair.

• Funnelmesh achieved the highest efficacy for recurrence reduction at 91.55%, outperforming keyhole and traditional repairs.
• Modified keyhole ranked safest, with a significant decrease in complications compared to other techniques.

Surgeons should consider funnelmesh and modified keyhole for optimal patient outcomes while reassessing the traditional keyhole technique, which has high failure rates.

• Sandwich technique ranked second for recurrence prevention with an 80% score.