A Case of Adult Umbilical Hernia Associated with Autosomal Dominant Multiple Cystic Kidney Disease Treated with the Subcutaneous Onlay Endoscopic Approach

Abstract

A 45-year-old man presented with a chief complaint of distention of the umbilical region. He had a history of autosomal dominant polycystic kidney disease (ADPKD), a distended abdomen, and a 3.5-cm bulge in the umbilical region. A 17-mm-diameter hernia portal was observed on computed tomography, which was consistent with the umbilical region. Although the working space was more limited than usual due to the increased volume of the abdominal cavity caused by multiple hepatorenal cysts associated with ADPKD, the anterior layer of the anterior sheath of the rectus abdominis muscle was maintained, and the umbilical hernia was safely and adequately dissected. Dissection was safe and adequate. A 2-cm hernia portal was observed at the umbilical region, and an onlay mesh was placed after suture closure. The SubCutaneous OnLay endoscopic Approach (SCOLA) technique is a safe and minimally invasive approach for patients with increased abdominal cavity volume due to ADPKD, as in this case.