Diaphragmatic hernia after minimally invasive esophagectomy

Abstract

Diaphragmatic hernia is an uncommon complication that can follow transhiatal esophagectomy. It has not been reported after minimally invasive esophagectomy. We report such a case presenting with features of small bowel obstruction. The paucity of adhesions following the combined laparoscopic and thoracoscopic approach may confer an increased risk of this complication.

Diaphragmatic herniation following esophagogastric resectional surgery: an increasing problem with minimally invasive techniques?

“…Possible hypotheses include reduction in intraabdominal adhesions with laparoscopic surgery [7]. We found that PODH rates were highest in hybrid operations (10.4 %) and MIO procedures (6.8 %), perhaps going against this hypothesis.…”

“…There are cited disadvantages, including higher rates of gastric conduit necrosis and anastomotic leak [5,6]. In addition, there are increasing reports of diaphragmatic herniation following esophagectomy performed using minimally invasive techniques [7,8].…”

Thoracoscopic and laparoscopic esophagectomy: initial experience and outcomes

“…The details of this problem have been described elsewhere [1]. In another patient, a port-site metastasis developed at the site of the previous umbilical incision just before the patient died from extensive systemic metastatic disease.…”

Incidence of diaphragmatic hernias following minimally invasive versus open transthoracic Ivor Lewis McKeown esophagectomy

“…One of the complications of esophagectomy is para-gastric diaphragmatic herniation of abdominal viscera. In minimally invasive surgery, adhesion formation is reduced as compared to open technique and so, theoretically, the laparoscopic approach increases the risk of herniation [7,8].…”