Laparoscopic diaphragmatic hernia repair

Abstract

Adult-congenital diaphragmatic hernia and chronic traumatic diaphragmatic hernia are amenable to laparoscopic repair. Although experience is still limited, laparoscopic repair appears safe and is associated with a shorter hospital stay.

Presentation and management of Morgagni hernias in adults: a review of 298 cases

“…Management of the hernia sac is a key decision point for many surgeons, and their opinion on this issue may affect their surgical approach. The natural history of an unexcised hernia sac has not been studied extensively [10,78]. Ramachandran and Arora [72] reported complete resolution of an unexcised sac by CT scan 1 month postoperatively.…”

“…This defect also is referred to as the space of Larrey, Napoleon's surgeon, who described the retrosternal space as an avenue through which pericardial tamponade could be treated [9]. Some authors refer to the potential retrosternal space on the right as ''Morgagni's gap'' and the space on the left as ''Larrey's gap'' [10].…”

“…Although incarceration and even strangulation of hernia contents have been reported [48,86,87], hernia contents usually are not incarcerated and reduce without much difficulty [14]. To avoid tension, Thoman et al [10] recommend using prosthetic mesh to cover defects larger than 20-30 cm 2 . Others recommend using mesh repairs in all cases except those involving neonates [88].…”

Laparoscopic repair of adult diaphragmatic hernias and eventration with primary sutured closure and prosthetic reinforcement: a retrospective study

“…However, a subset of patients (5-10%) may present in adulthood with a congenital hernia undetected during childhood [4]. This study essentially deals with this subset of patients.…”

Laparoscopic Treatment of Morgagni Hernia: Report of Three Cases

“…Investigations suggest that these hernias can be acquired through congenital defects in the diaphragm (Larrey's space) 6,12 . Th e sequence of events implies herniation of abdominal organs through the existing diaphragmatic gap.…”