Technical note on augmentation of diaphragmatic herniorrhaphy using the renal capsule

This technical note describes a surgical technique for repairing a right dorsal crural diaphragmatic hernia and reports postoperative outcomes. Two client-owned dogs were referred for a diaphragmatic hernia diagnosed via thoracic radiographs, suspected to be chronic and secondary to trauma. During surgery, a hernia was identified in the right dorsal crus of the diaphragm, and herniated contents were reduced. In Dog 1, the lateral aspect of the defect was closed using mattress sutures; however, insufficient local tissue precluded complete primary closure. To address this, the soft tissues lateral and dorsal to the caudal vena cava were sutured to the right renal capsule using mattress and cruciate sutures. The diaphragm was then anchored to the renal capsule laterally with mattress sutures to cover the residual defect. In Dog 2, the hernia was closed with cruciate sutures along the hernia edge, around the ribs, and into the deep fascia. Although most of the defect was closed, the right renal capsule was sutured over the dorsal hernia closure using cruciate sutures to seal small residual rents and augment the repair. Objective follow-up periods were 134 days for Dog 1 and 27 weeks for Dog 2 (owner telephone calls at 13 and 9 months, respectively). No hernia recurrence or hernia- or surgery-related clinical signs were observed. This study describes renal capsular-augmented diaphragmatic herniorrhaphy for repairing right dorsal crus defects when local tissue is limited.