Abstract
The patient was a 70-year-old man who had been on continuous ambulatory peritoneal dialysis in a steady state since about 4 years earlier when the peritoneal dialysis was introduced for chronic renal failure. Recently a bulge became to appear at the left inguinal region when perfusion solution for the dialysis was infused. Close examinations including ultrasonography and abdominal CT scan revealed a diagnosis of inguinal hernia, and he was referred to our department for the purpose of surgery and treatment. When we explained the operative procedures to him, he hoped to undergo a laparoscopic surgery. After gaining written informed consent from him for the operation by explaining detailed procedures including a possibility of conversion to an open anterior approach if we were unable to perform laparoscopic procedures, we performed laparoscopic transabdominal preperitoneal inguinal hernia repair. We started to operate laparoscopic procedures by using three ports under general anesthesia. Thickening of the peritoneum and severe adhesions were absent, no intra- and post-operative complications occurred, and we followed normal operational procedure to complete the repair safely. The patient resumed peritoneal dialysis in an early time after the operation, and he was discharged from the hospital on the second postoperative day. No recurrence was proved on an abdominal CT scan conducted about one year after the operation.
