What Kind of Incision Should Be Made to Reduce the Risk of Incisional Hernia in Kidney Transplantation?

BACKGROUND: The incidence of incisional hernia following renal transplantation is 1.1% to 3.8%. The risk factors are immunosuppressive medications, impaired tissue quality, neuromuscular trauma due to the operation, and denervation. The incidence has been decreasing based on the shift from hockey-stick incision method to inguinal oblique incision method. The aim of this study was to minimize the development of incisional hernias due to renal transplantation. MATERIAL/METHODS: Twenty-four patients who underwent renal transplantation in 2015–2017 were retrospectively examined. All transplantations were performed with oblique incisions of 10–15 cm in the right or left inguinal region using polydioxanone (No. 2) loop sutures and continuous technique. RESULTS: The mean age of study patients was 43 years (range 24–67 years). The mean body mass index (BMI) was 29 kg/m(2) (range 25–38 kg/m(2)). Of these patients, one had diabetes mellitus, two had chronic pulmonary disease, six were obese, one had poliomyelitis sequelae, and seven had hypoalbuminemia. None of the patients had ascites; five patients had a history of surgery for peritoneal dialysis. At the end of the one-year follow-up period, none of the patients had developed an incisional hernia. CONCLUSIONS: We conclude that using the smallest possible semilunar line incision in the inguinal region would aid in preventing post-transplantation incisional hernias.