Laparoscopic repair of peritoneopericardial hernias: Multicentric retrospective case series of 12 dogs and one cat.

Abstract

OBJECTIVE: To date, there is little evidence on laparoscopic repair of peritoneopericardial diaphragmatic hernias (PPDH). The present study reports on surgical technique considerations, complications and outcome. STUDY DESIGN: This was a multicentric retrospective cohort study of patients with laparoscopic PPDH repairs, using low-pressure COinsufflation (3-4 mmHg) who were operated between October 2022 to November 2024 in two specialist centers. ANIMALS: Dog and cat patients were diagnosed with PPDH and treated laparoscopically using low-pressure COinsufflation (3-4 mmHg). Patients were either symptomatic or their owners wished for repair. METHODS: Demographics of patients and details of surgical procedures including follow-up were reported in simple observational statistics. Details of surgical procedures included extent of PPDH, number of ports, insufflation pressure, suture use, use of thoracocentesis with an 18 gauge needle and/or drain, operating and total surgical time, anesthetic and surgical complications during and after surgery and a follow up at 6 months. RESULTS: Twelve canine and one feline patient were included in the study. One case required conversion to open surgery due to CO-induced pericardial tamponade. All patients survived and had no serious complications. CONCLUSION: Full laparoscopic repair of PPDH using low insufflation pressure was successfully achieved in 92% (12/13) patients. CLINICAL SIGNIFICANCE: This is the largest case series to report on outcomes of laparoscopic repairs of PPDH. Laparoscopic treatment of PPDH is a viable option without increased risk of complications.