Repair of Inguinal Hernia on the Side of a Renal Transplant Using Lichtenstein's Procedure following Laparoscopic Observation—A Case Report—

Abstract

The repair of inguinal hernia on the side of a renal transplant is often challenging because of difficulties in identifying the anatomy, including the transplanted ureter. In this report, we describe a case in which a bilateral inguinal hernia was safely repaired after renal transplantation using a fluorescence-guided ureteral catheter to identify the transplanted ureter. The patient was a 61-year-old man who had received a living renal transplant in the right iliac fossa for chronic renal failure owing to multiple cystic kidneys 7 years earlier. Following close examination and intraperitoneal observation for bilateral inguinal hernias, the patient underwent repair using the Lichtenstein procedure. A fluorescent catheter was placed in the transplanted ureter preoperatively and light was emitted intraoperatively, enabling safe performing of the operation and checking of the transplanted ureter at any time. A literature review revealed cases in which reoperation was required because of damage to the transplanted ureter or bladder injury. We believe that understanding anatomy with fluorescence guidance is a valuable technique to enhance safety of surgical procedures.