pp 1–6 | Cite as

Hernia repair and simultaneous continuous ambulatory peritoneal dialysis (CAPD) catheter implantation: feasibility and outcome

  • P. Horvath
  • A. Königsrainer
  • T. Mühlbacher
  • K. Thiel
  • C. ThielEmail author
Original Article



Occurrence of abdominal wall hernias during and before peritoneal dialysis constitutes a pivotal role in treatment discontinuation, failure, and exclusion from this dialysis method. We herein present a single-center experience regarding a one-stage surgical strategy, including hernia repair and simultaneous peritoneal dialysis catheter implantation.

Patients and methods

Over a 4-year period, 123 patients underwent peritoneal dialysis catheter implantation and 23 patients (19%) had concomitant abdominal wall hernias and were enrolled in this monocentric prospective study. Data collection included recurrent and new-onset hernias, surgical site infection, 1-year and 2-year catheter survival.


In 23 patients, 27 hernia repairs combined with peritoneal dialysis catheter implantation were performed. Median age was 52 years (range, 30–85 years) and 18/23 (78%) patients were male. There were no recurrent hernias and no early surgical site infections. Daily flushing was regularly started on the 1st to 3rd postoperative day. Five patients (22%) developed hernias on other anatomical sites, which required hernia repair and perioperative discontinuation of peritoneal dialysis. After a median follow-up of 37 months (range, 28–87 months), 96% of all implanted catheters were still working.


Hernia repair and simultaneous peritoneal dialysis catheter implantation are associated with no recurrent hernias, an early start of peritoneal dialysis, a very low postoperative morbidity and very high 1-year and 2-year catheter survival.


Peritoneal dialysis Hernia repair Recurrent hernia 


Author contribution

CT and KT: development of study design, critical review of the manuscript, analysis, and interpretation of data. PH: acquisition of data, drafting of the manuscript, analysis, and interpretation of data. AK and TM: critical review of the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Human and animal rights

The procedures describes in this study were in accordance with the ethical standards of the responsible committee on human experimentation.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Bellizzi V, Giannoulias D, Alsunaid M, Tziviskou E, Aggrawal HK, Khandelwal M, Bargman JM, Jassal SV, Vas SI, Oreopoulos DG (2003) Gynecological surgery: not a contraindication for continuation of CAPD. Perit Dial Int 23:193–196PubMedGoogle Scholar
  2. 2.
    Nicholson ML, Madden AM, Veitch PS, Donnelly PK (1988) Combined abdominal hernia repair and continuous ambulatory peritoneal dialysis (CAPD) catheter insertion. Perit Dial Int 9:307–308Google Scholar
  3. 3.
    Garcia-Toledo M, Borras Sans M, Gabarell A, Duran J, Fernandez Giraldez E (2011) Risk factors for abdominal wall hernia in patients undergoing peritoneal dialysis. Nefrologica 31:218–219. CrossRefGoogle Scholar
  4. 4.
    Del Peso G, Bajo MA, Costero O, Hevia C, Gil F, Diaz G, Aguilera A, Selgas R (2003) Risk factors for abdominal wall complications in peritoneal dialysis patients. Perit Dial Int 23:249–254PubMedGoogle Scholar
  5. 5.
    Garcia-Urena MA, Rodriguez CR, Ruiz VV, Carnero Hernandez FJ, Fernandez-Ruiz E, Vazquez Gallego JM, Velasco García M (2006) Prevalence and management of hernias in peritoneal dialysis patients. Perit Dial Int 26:198–202PubMedGoogle Scholar
  6. 6.
    Dombros N, Dratwa M, Feriani M, Gokal R, Heimbürger O, Krediet R, Plum J, Rodrigues A, Selgas R, Struijk D, Verger C, EBPG Expert Group on Peritoneal Dialysis (2005) European best practice guidelines for peritoneal dialysis. Nephrol Dial Transplant 20:ix3–ix7CrossRefGoogle Scholar
  7. 7.
    Yang YF, Wang HJ, Yeh CC, Lin HH, Huang CC (2011) Early initiation of continuous ambulatory peritoneal dialysis in patients undergoing surgical implantation of Tenckhoff-catheters. Perit Dial Int 31:551–557CrossRefGoogle Scholar
  8. 8.
    Shah H, Chu M, Bargman JM (2006) Perioperative management of peritoneal dialysis patients undergoing hernia surgery without use of interim hemodialysis. Perit Dial Int 26:684–687PubMedGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  • P. Horvath
    • 1
  • A. Königsrainer
    • 1
  • T. Mühlbacher
    • 2
  • K. Thiel
    • 1
  • C. Thiel
    • 1
    Email author
  1. 1.Department of General, Visceral and Transplant SurgeryUniversity of Tübingen, Comprehensive Cancer CenterTuebingenGermany
  2. 2.Division of Endocrinology, Diabetology, Vascular Disease, Nephrology and Clinical Chemistry, Department of Internal MedicineUniversity Hospital TuebingenTuebingenGermany

Personalised recommendations