Laparoscopic extra-abdominal suturing technique for the repair of Larrey’s diaphragmatic hernia using the port closure needle (Endo Close ® ): A case report

Yamamoto, Yuji; Tanabe, Kazuaki; Hotta, Ryuichi; Fujikuni, Nobuaki; Adachi, Tomohiko; Misumi, Toshihiro; Saeki, Yoshihiro; Takehara, Hiroki; Ohdan, Hideki

doi:10.1016/j.ijscr.2016.09.010

Cited by 8 publications

(18 citation statements)

References 9 publications

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“…Only 4% of the reported cases are bilateral. The defect results from a fusion failure of the diaphragm with the costal arches [2][3][4][5][6]. Sanford et al reported that the average length of the diaphragmatic defect in the greatest dimension is 7.5 cm [6].…”

Section: Discussionmentioning

confidence: 99%

Symptomatic congenital Morgagni hernia presenting as a chest pain: a case report

et al. 2020

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Background: Morgagni hernia is a rare form of congenital diaphragmatic hernia with a prevalence of 2-3%. It occurs due to a defect on the anterior part of the diaphragm, which allows abdominal organs to penetrate into the thoracic cavity. This condition can be detected during fetal life by routine ultrasonography or late during adult life. Late diagnosis of this condition in adults is extremely rare. According to our literature search, only a few cases of symptomatic hernia in adults have been reported so far. Surgery provides definitive treatment for patients with Morgagni hernia; it is always recommended for symptomatic and asymptomatic adult patients to avoid future complications such as volvulus, small bowel obstruction, incarceration, or strangulation. We report a case of a patient who presented with chest pain due to newly diagnosed congenital diaphragmatic hernia. Case presentation: A 29-year-old unemployed white man with no significant past medical history or family history of coronary artery disease, who was a current smoker with a 1-pack-per-day history, presented to our hospital with a 1-month history of intermittent chest pain. His chest pain was localized to the right side with a pressure-like quality, moderate intensity 4-6/10, nonradiating, and relieved by standing up and worsened by lying flat. His pain was not associated with increase or decrease in activity level. The pain had progressively worsened, which prompted the patient to come to the emergency room. The patient was admitted for further evaluation. A chest x-ray showed a suspected loop of bowel on the right side of the chest. Subsequently, the patient underwent computed tomography of the chest, which revealed a 7-cm defect in the right hemidiaphragm with a large amount of intra-abdominal fat and a loop of the proximal transverse colon within the hernial sac. The patient was evaluated by a surgeon and eventually underwent laparoscopic repair of the diaphragmatic hernia with mesh repair. In follow-up, the patient's symptoms resolved. Conclusion: Morgagni hernia is a rare form of congenital diaphragmatic hernia. It is commonly found either in the first few hours of life or in the antenatal period. It is less common in adults and is usually diagnosed accidentally in asymptomatic patients. Symptomatic adult cases are extremely rare. Respiratory symptoms are the most common presenting symptoms. The primary management for both symptomatic and incidentally discovered asymptomatic cases of Morgagni hernia is surgical correction. Various thoracic and abdominal surgical approaches have been described without a clear consensus on preference for operative repair technique.

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Section: Discussionmentioning

confidence: 99%

Symptomatic congenital Morgagni hernia presenting as a chest pain: a case report

et al. 2020

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“…laparoscopic or thoracoscopic approach. The well-known advantages of the minimally invasive treatment, including the faster postoperative recovery, as well as the shorter hospitalization period and minimal scarring, urged an increased number of surgeons to treat the patients in this manner in the last several years [1,14]. The robotic surgery, whether transabdominal or transthoracic, represents another technological progress with well-recognized advantages: ergonomics, preciseness of instruments, as well as easy operation in narrow spaces [15,16].…”

Section: Discussionmentioning

confidence: 99%

“…The robotic surgery, whether transabdominal or transthoracic, represents another technological progress with well-recognized advantages: ergonomics, preciseness of instruments, as well as easy operation in narrow spaces [15,16]. With regard to the treatment with a small-diameter hernia opening (less than 16 cm 2 ), it is possible to perform a primary suture, while in larger defects (larger than 20-30 cm 2 ), the plastics of the diaphragm opening is induced with the help of various kinds of meshes, to avoid tension [14]. The data from the literature indicate that polypropylene meshes are mainly applied, but the possibility of using other types of meshes has not been excluded [17].…”

Section: Discussionmentioning

confidence: 99%

Larrey diaphragmatic hernia in an adult

et al. 2020

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Introduction Larrey hernia is a very rare type of the left sided parasternal congenital hernia with the incidence of 1-3% of all anterior diaphragmatic hernias. Case report The paper describes Larrey congenital diaphragmatic hernia in an adult female patient, aged 70 years. Seventeen years earlier, the patient had had problems with intermittent left side chest pain, hypertension, dyspnea, shortness of breath, fatigue, and abdominal discomfort. She had no past surgical history, and no traumatic rupture of the diaphragm. An open surgical repair was conducted, reducing the herniated organs back into the abdominal cavity, and closing the diaphragmatic defect, repaired with a non-absorbable suture. During the immediate postoperative period, as well as six months later, the patient had a remarkable postoperative recovery. Conclusion Larrey hernia represents an extremely rare kind of the anterior diaphragm hernias, which can be symptomatically manifested in older persons over 65 years of age. The treatment in the cases of asymptomatic and symptomatic Larrey hernias is a surgical intervention.

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“…Nonabsorbable 00 sutures are preferred for primary repair. In the transfacial extracorporeal technique, Endo Close® is inserted into the abdomen through mini incisions (described by Yamamato) [28], and the sutures that were previously sent into the abdomen are held one by one and pulled out of the abdomen and ligated to the hernia defect. The sutures are passed one by one 1 or 2 cm apart and are thrown to cover the cranial and caudal borders of the hernia defect.…”

Section: Surgical Indicationmentioning

confidence: 99%

Laparoscopic Rare Abdominal Hernia Treatment

Akın¹,

Mantoğlu²,

Altıntoprak³

et al. 2019

Hernia Surgery [Working Title]

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Diaphragm and abdominal wall hernias are rare, and they may be congenital or acquired. Spiegel hernia incidence is between 0.1 and 2%. Morgagni hernia is comprising only 2-3% of all diaphragmatic hernias. Most Spiegel and Morgagni hernias are diagnosed late because of their non-specific symptoms and asymptomatic clinical presentation. The major symptoms are abdominal pain, vomiting, and dyspnea. Computed tomography (CT) shows the hernia sac content, strangulation or incarceration in the content, and detailed anatomical information about surrounding tissue. Surgery is the main treatment option except patients who have severe comorbidity. Spiegel hernia surgery can be performed open or laparoscopic. Intraperitoneal onlay mesh (IPOM), total extraperitoneal procedure (TEP), transabdominal preperitoneal (TAPP) procedure, or partial transabdominal laparoscopic methods are minimal invasive surgery options. In the repair of Morgagni hernia, surgical options may be laparoscopy, laparotomy, thoracotomy, or thoracoscopy.

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Laparoscopic extra-abdominal suturing technique for the repair of Larrey’s diaphragmatic hernia using the port closure needle (Endo Close ® ): A case report

Abstract: HighlightsLarrey’s diaphragmatic hernia is relatively uncommon.It is difficult to suture the hernial orifice laparoscopically.Extra-abdominal suturing technique using Endo Close® may be useful in terms of secure suture and easy tying.

Cited by 8 publications

References 9 publications

Symptomatic congenital Morgagni hernia presenting as a chest pain: a case report

Symptomatic congenital Morgagni hernia presenting as a chest pain: a case report

Larrey diaphragmatic hernia in an adult

Laparoscopic Rare Abdominal Hernia Treatment

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