# Simultaneous Laparoscopic Ventral Hernia Repair and Peritoneal Dialysis Catheter Placement in Patients With Chronic Renal Failure: A Single-Center Retrospective Analysis

## TL;DR

This study shows that laparoscopic surgery can safely repair hernias and place dialysis catheters at the same time in patients with kidney failure.

## Contribution

The study demonstrates the safety and effectiveness of simultaneous laparoscopic hernia repair and dialysis catheter placement in PD patients.

## Key findings

- Mean operative time was 40 minutes with minimal blood loss.
- No major complications or hernia recurrences were observed during follow-up.
- Early dialysis initiation was achieved without catheter malfunction.

## Abstract

Background

In patients undergoing peritoneal dialysis (PD), there is a high incidence of ventral hernia during the first five years of follow-up. Early diagnosis of the occurrence of ventral hernias in PD patients is very important to ensure their surgical treatment as quickly as possible.

Methods

A retrospective analysis of prospectively collected data was conducted between January 2022 and May 2023. All patients who have undergone peritoneal catheter implantation by laparoscopy and concomitant ventral hernia repair according to the laparoscopic intra-peritoneal onlay mesh technique were enrolled. Primary outcomes include operative time, blood loss volume, conversion to open surgery, hospital stay, hematoma, chronic pain, complication rate according to Clavien Dindo score, hernia recurrences, and peritoneal catheter displacement or malfunction.

Results

The mean operative time was 40 minutes (range: 30-60 minutes). Intraoperative blood loss was less than 30 ml. No conversion to laparotomy was needed. Considering a mean follow-up of six months, no Clavien Dindo grade > 2 was recorded. One hematoma appeared on postoperative day 4. No chronic pain, defined as pain lasting >3 months, was recorded. No hernia recurrence was registered, but one was an asymptomatic bulging Early initiation of PD was achieved, with no reported malfunctions of the peritoneal catheter or infusion system to date.

Conclusion

For patients on PD with ventral hernia, laparoscopic intraperitoneal onlay mesh (IPOM) repair has the advantages of less trauma, simultaneous treatment of occult hernias, adjustment and fixation of PD tubes, low incision complication rates, and low recurrence rates. IPOM repair can be performed safely and effectively in this population group; thus, it is a procedure worth promoting.