Morgagni's Hernia Resolved by Laparoscopic Surgery

Abstract

Morgagni's hernias represent between 2 and 4% of the whole of nontraumatic diaphragmatic hernias in the adult, and the treatment (even with minimal symptoms) is always with surgery. We present the case of a 50-year-old woman with an oppressive, postprandial discomfort in the right side of her thorax and with increased pain when supine. The x-ray examination indicated a large portion of transverse colon inside the thoracic cavity. Once the diagnosis of Morgagni's hernia had been obtained, she was scheduled for laparoscopic surgery to reduce the hernia and to reconstruct the defect of the diaphragm using a polypropylene mesh.

Laparoscopic-assisted repair of Morgagni hernia in children

“…In follow-up x-rays, there was complete obliteration of the residual cavity in all cases except one who had very tiny airfilled area just above the diaphragm 6 months after the repair. Obliteration of the residual cavity has been reported by other authors as well [14,15].…”

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

“…Based on the opinions of several authors, achieving at least 1.5 to 2.5 cm overlap of the mesh is preferred [89,91,92]. Of those authors who have used polypropylene mesh to repair the defect, 29% (5/17) do not cover the mesh [25,72,95] because they think the round ligament, liver, and omentum provide ample protection for the bowel [12,70]. This concept may not apply to left-sided hernias.…”

“…This concept may not apply to left-sided hernias. However, tissue coverage of the mesh can be achieved with omentum [93], peritoneal flap [81,83], falciform ligamament/ligamentum teres [85], or nothing [25,72,95]. Mesh fixation can be performed with surgical tacks or various laparoscopic suturing techniques.…”

Single-port laparoscopic repair of a Morgagni diaphragmatic hernia in a pediatric patient: advancement in single-port technology allows effective intracorporeal suturing

“…Although there have been reports of both laparoscopic and thoracoscopic Morgagni hernia repair [2][3][4][5], to our knowledge, this is the first report of such a defect being closed using a single-port technique in a pediatric patient. This represents a technical step forward, not only because it proves the feasibility of this particular procedure, but also because it represents the next phase of advancement in pediatric minimally invasive surgery.…”

“…The traditional repair of this anomaly is performed through an open upper right quadrant abdominal incision; however, more recently, both laparoscopic and thoracoscopic approaches have been reported [2][3][4][5]. We present the first case (to our knowledge) of a right anterior diaphragmatic hernia repaired by a singleport laparoscopic technique.…”