2023 Volume 56 Issue 11 Pages 608-614
Renal transplants are increasing in Japan, but inguinal hernia surgery after renal transplantation is still rare. The patient was a 60-year-old man with a history of renal transplantation to the right iliac fossa, which was discontinued and he was managed on dialysis. The patient presented with a right medial inguinal hernia that had been repaired and was manually repatriated. Three days later, he presented with intestinal obstruction due to edema of the small intestine. There was no evidence of intestinal necrosis and the patient was treated conservatively. Thirty days after the initial visit, a laparoscopic transabdominal preperitoneal approach (TAPP) was performed. As far as we could observe, there were no abnormalities in the small intestine. The anatomy was difficult to identify because of adhesions in the preperitoneal space. Only the hernia portal was covered with mesh, and the ureter and transplanted kidney were not damaged. The Lichtenstein procedure is recommended because of its reduced dissection of the preperitoneal space, although TAPP for transplant side inguinal hernia after renal transplantation is an option for a skilled surgeon.
