Combined laparoscopic peritoneal dialysis catheter insertion and epigastric hernia repair to avoid delaying dialysis

Abstract

We describe a simple technique to repair simultaneously an epigastric hernia and laparoscopically site a peritoneal dialysis catheter (PDC) without the need to delay dialysis. An open dissection is performed to achieve a pneumoperitoneum by placing camera port through the hernial sac (Fig. 1). With the patient in the Trendelenberg position, a second incision is made and a PDC on an introducer is sited percutaneously into the pelvic sump. Figure 1 Laparoscopic port insertion through ventral hernial defect to allow simultaneous peritoneal tube placement and hernia repair. After the cuff is placed anterior to the peritoneum, the PDC may then be tunnelled laterally. The camera port is removed and the defect repaired with 1/0 nylon.