Laparoscopic approach for diaphragmatic hernia repair in adult: our experience of four cases

Abstract

Diaphragmatic hernia can be congenital or acquired. Usual clinical presentation may range from asymptomatic cases to serious respiratory/gastrointestinal symptoms and occasionally atypical presentation as lumbar hernia also. The diagnosis of diaphragmatic hernia is based on clinical investigation and is confirmed by plain X-ray film and computed tomography scan. Various treatment approaches, open, laparoscopic and combination, are available for this condition. However, laparoscopic approach has recently gained in popularity. Surgical repair typically involves primary or patch closure of the diaphragm through an open or endoscopic abdominal or thoracic approach. This paper reflects our experience of repair of diaphragmatic hernias to evaluate its safety, efficacy and outcomes.

Trapped diaphragmatic hernia with necrosis of the gastric wall – Case Report and literature review

“…Published studies show that laparoscopic procedures are safe and cause relatively few complications. In a published series of clinical cases [22], none of the four patients involved had postoperative complications [22]. Laparoscopic surgery was a complete success in all cases [22].…”

“…In a published series of clinical cases [22], none of the four patients involved had postoperative complications [22]. Laparoscopic surgery was a complete success in all cases [22]. In only one case it was necessary to add mini-thoracotomy in the laparoscopic access (hybrid technique) in order to reduce the content [22].…”

“…Laparoscopic surgery was a complete success in all cases [22]. In only one case it was necessary to add mini-thoracotomy in the laparoscopic access (hybrid technique) in order to reduce the content [22]. The defect was corrected with a polypropylene suture and reinforced with a mesh [22].…”

“…The treatment of diaphragmatic hernia is surgical and usually involves flap closure of the diaphragm using an open or endoscopic method (access can be through the abdomen or through the chest), or combined techniques [22]. Laparoscopic treatment has many advantages, the most important of all is certainly less invasiveness during the procedure, but it is also worth paying attention to aesthetic issues.…”

Laparoscopic approach in chronic posttraumatic diaphragmatic hernia

“…The benefits of the abdominal approach over the thoracic approach are assessment of both diaphragms and management of visceral organs incarceration. The choice of approach depends on the presence of associated injuries, surgeon expertise and preference [ 4 , 5 ].…”