Transabdominal Preperitoneal Hernia Repair in Peritoneal Dialysis Patients

Area of Science:

• Surgery
• Nephrology
• Gastroenterology

Background:

• Patients on peritoneal dialysis (PD) face an increased risk of inguinal hernias.
• Current surgical guidelines for inguinal hernia repair in PD patients are lacking.
• Open inguinal hernia repair is the traditional approach.

Purpose of the Study:

• To evaluate the safety and efficacy of transabdominal preperitoneal hernia repair (TAPP) in patients undergoing peritoneal dialysis (PD).

Main Methods:

• A retrospective review of four PD patients who underwent TAPP between October 2018 and October 2022.
• Data collected included patient demographics, hernia characteristics, operative time, and postoperative outcomes.
• Assessment of complications, dialysis resumption, and hernia recurrence.

Main Results:

• The median patient age was 80.5 years (range: 67-88), and all were male.
• Two patients had bilateral inguinal hernias; all were lateral inguinal hernias.
• Median operative time was 80.5 minutes (range: 56-141 min).
• No intraoperative or postoperative complications were reported.
• Peritoneal dialysis was resumed on postoperative day 6 (range: 2-7 days).
• No instances of dialysate leakage, infection, or hernia recurrence were observed.

Conclusions:

• Transabdominal preperitoneal hernia repair (TAPP) can be safely performed in patients on peritoneal dialysis (PD).
• TAPP offers a viable surgical alternative for inguinal hernia repair in this patient population.
• The procedure demonstrated favorable outcomes regarding complications and dialysis continuation.