Incisional hernia development after live donor nephrectomy: Impact of surgical technique

Background: Characteristics of incisional hernia (IH) formation following live donor nephrectomy (LDN) are not well defined. The goal of this study was to describe the incidence of IH within 3 years following LDN and identify risk factors contributing to their formation. Materials and methods: We performed a single center, retrospective review of all LDN between February 2013 to October 2018. Patients with and without IH were compared based on donor and operative variables. Data were analyzed using chi square tests with column proportions. Multivariable logistic regression with backwards elimination was used to evaluate the likelihood of IH based on potential risk factors. Results: Three hundred and one individuals underwent live donor nephrectomy. Twenty-eight patients (9.3%) developed an incisional hernia with median time to development of 7 months (range: 2-24 months). Obesity [Body Mass Index (BMI) ≥30], periumbilical hand port, and vertical infraumbilical hand port were associated with increased risk of IH development on univariate analysis. On multivariate analysis, obesity and periumbilical hand port location were persistent risk factors for IH. Conclusions: The incidence of IH following LDN is prevalent and associated with obesity and operative technique. Placing the hand port infraumbilical with a transverse fascial incision may reduce the risk of IH following LDN.