Technical note on augmentation of diaphragmatic herniorrhaphy using the renal capsule.

Renal capsular augmentation enables successful diaphragmatic hernia repair when local tissue is insufficient.

This technical note presents a novel surgical approach for repairing right dorsal crural diaphragmatic hernias in dogs when primary closure is compromised by insufficient local tissue. Two client-owned dogs with chronic diaphragmatic hernias secondary to trauma underwent surgical repair with renal capsular augmentation. In Dog 1, the hernia defect could not be completely closed with primary suturing alone, necessitating mobilization of soft tissues lateral and dorsal to the caudal vena cava, which were then sutured to the right renal capsule using mattress and cruciate patterns. The diaphragm was subsequently anchored to the renal capsule to cover the residual defect. Dog 2's hernia was primarily closed with cruciate sutures around the hernia edges, ribs, and deep fascia, with renal capsule augmentation used to seal and reinforce small remaining rents. Both dogs demonstrated excellent long-term outcomes with follow-up periods of 134 days and 27 weeks, respectively, with telephone follow-up extending to 13 and 9 months. No hernia recurrence or related clinical complications were observed in either case. This technique represents a valuable surgical option when standard diaphragmatic herniorrhaphy is limited by inadequate local tissue availability.

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