Einstein (São Paulo) (Sep 2005)
Laparoscopic treatment for incisional lumbar hernia in kidney donor: a new minimally invasive and efficient alternative
Abstract
This report describes and discusses a new therapeutic laparoscopictechnique for incisional hernia secondary to lumbotomy in a kidneydonor. The transperitoneal laparoscopic approach was used with thepatient placed in left lateral decubitus. Three trocars were placedduring the surgery: the first, a 10-mm trocar at the level of the umbilicalscar; the second, a 5-mm trocar at the mid-clavicular line, 2 cm belowthe navel; and the third, a 12-mm trocar at the midline, between thenavel and the xiphoid process. The peritoneum was detached fromthe abdominal wall laterally to the hernia defect and parallel to thecolon inferiorly until complete exposure of the limits of the hernia ringwas achieved. A polypropylene mesh was placed in the abdominalcavity and fixed along the borders of the previously dissected andprepared hernia ring with titanium staples. Operative time was 148minutes and the patient was discharged 24 hours after the surgery.There was no intraoperative complication and no hernia recurrenceduring a 15-month follow-up. The patient resumed regular activities 3weeks after the surgery. We concluded that the repair of the incisionallumbar hernia in kidney donor via laparoscopic approach was a goodminimally invasive treatment option, with adequate functional andcosmetic results. The technique provided excellent exposure andview of the anatomical structures, with reduced pain, shorter recoverytime and earlier return to activities of daily life.
