Percutaneous suturing technique and single-site umbilical laparoscopic repair of a Morgagni hernia: Review of three cases

Zouari, Mohamed; Jallouli, Mohamed; Bendhaou, Mahdi; Zitouni, Hayet; Mhiri, Riadh

doi:10.1016/j.arcped.2015.09.017

Cited by 10 publications

(9 citation statements)

References 20 publications

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“…To assist in the repair, in one child, an optical foreignbody forceps of a bronchoscope [10] was used. There was another report using a homemade single-port device with a wound retractor and a surgical glove [13]. Additional simultaneous procedures were only performed in two children, both of which were gastrostomies.…”

Section: Resultsmentioning

confidence: 99%

“…An optic port is introduced through an umbilical incision. In early reports, a 12 mm or 10 mm scope was used [37,38], while, later, surgeons preferred a smaller 5 mm scope [9,10,13,22]. Almost ¾ of the laparoscopies were performed using three ports.…”

Section: Discussionmentioning

confidence: 99%

“…In a few cases, a single-port technique was possible. Zouari et al [13] fashioned a homemade single port by placing a glove with a wound retractor through which a camera and a grasper could be introduced. Yilmaz et al [10] used an optical foreign-body forceps of a bronchoscope.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic Morgagni hernia repair in children: systematic review

Alqadi

Saxena

2019

J Ped Endosc Surg

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Aim This study performed a systematic review on procedures, instruments, techniques, and outcomes of laparoscopy in children with Morgagni hernias (MH). Methods The literature was reviewed for articles online on PubMed with search terms "laparoscopy", "Morgagni", "hernia", and "children". The inclusion criteria included articles only in English, and in the pediatric age group of 0-18. Articles that did not meet the inclusion criteria were excluded. Results The literature search from 1997 to 2019 revealed 32 articles that met the inclusion criteria. A total of 201 children were analyzed for laparoscopic repair of MH with age range 1 month-14 years. Sixty-four children had chest infections and n = 58 were asymptomatic. Laparoscopic procedures were carried out using a single-port technique (n = 9) or 3 ports (n = 145). There was a 30° scope preference in 47 children. In 97 children, the falciform ligament was divided. The preferred technique was primary closure using either intracorporeal (n = 18) or extracorporeal (n = 183) knot tying techniques, using non-absorbable sutures in all but four cases. Resection of the sac was reported in 42 patients. However, in 21 patients, there were large-size defects that required patch repairs. Some surgeons (n = 8) opted for suture devices. Robotic repairs were performed in 4 children. There were 7 conversions. Postoperative complications included 10 recurrent hernias, 3 residual sacs, and 1 port site hernia. With regards to associated conditions, 30 children had Down's syndrome, 13 other chromosome abnormalities, 16 cardiac malformations, and 4 gastroesophageal reflux disease. There was 1 lethal outcome due to respiratory complications. Conclusions Repair of MH is preferred only through the laparoscopic approach. Almost one-third of the patients have an associated condition. Repairs are associated with patches in one-tenth cases. Conversion in repairs is extremely low and is around 3.5%. Recurrence after laparoscopic approach is estimated to 5%.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Laparoscopic Morgagni hernia repair in children: systematic review

Alqadi

Saxena

2019

J Ped Endosc Surg

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“…The laparoscopic approach becomes a gold standard, even in the case of children. An alternative solution to standard laparoscopic treatment is percutaneous suture of the diaphragmatic defect using a single umbilical trocar (24,25). The first case operated with the Da Vinci robot was reported (26).…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Management in Morgagni Hernia - Short Series and Review of Literature

Târcoveanu¹,

Georgescu²,

Vasilescu³

et al. 2018

chr

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Morgagni hernia occurs after a congenital retrosternal diaphragmatic defect; it is a rare form of diaphragmatic hernia (1-3% of cases). In general, this pathology is diagnosed in children; in adults it is frequently discovered in emergency or incidentally. We prospectively evaluated a series of 8 patients admitted to First Surgical Clinic, St. Spiridon Hospital, Iasi during the period 2011-2017. Out of 8 patients, 6 were operated on, one patient refusing surgery (followed periodically); the patient who was 91 years old had serious associated diseases that made surgery contraindicated. Symptomatology was nonspecific: in 5 cases Morgagni hernia was discovered during the exploration of an associated pathology, either with cardiopulmonary symptoms of dyspnea or palpitations. In 2 cases, the clinical aspect suggested an occlusive syndrome (the herniated organ is usually the transverse colon). The laparoscopic approach was used in all cases: two conversions were recorded due to the tight adherences of the herniated viscera (gastric, colon, epiplon). In 4 cases, the surgical cure of hernia was performed by suture and in 2 cases with prosthesis: dual mesh in one case and polypropylene mesh in another case. We did not register morbidity and the mean postoperative stay was 4 days (range 2-6 days). Hernia Morgagni betrays a rare pathology. The most common is asymptomatic but in complicated cases it is a cause of acute surgical abdomen. Surgical treatment is indicated even for asymptomatic cases due to serious complications Morgagni hernia may develop. The laparoscopic approach is ideal, as reduction of viscera in the abdomen is easy and the defect will be repaired by suturing or using a prosthesis, depending on its size.

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“…M H a c c o u n t e d f o r o n l y 1 -2 % o f a l l c o n g e n i t a l diaphragmatic hernia (1). The MH sac is most commonly on the right side and can contain small bowel, transverse colon, omentum, and rarely stomach or liver, furthermore, sustained or sudden severe increased intra-abdominal pressure, trauma or pregnancy could lead to the acute onset of MH, thus, if patients present with prolonged shortness of breath, or a right cardiophrenic angle lesion on chest radiograph, the diagnosis of a diaphragmatic hernia should be considered (2).…”

Section: Discussionmentioning

confidence: 99%

Non-intubated laparoscopic repair of giant Morgagni’s hernia for a young man

et al. 2016

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An asymptomatic patient was admitted as his chest photograph and computed tomography scans showed a giant Morgagni's hernia (MH). And it was repaired by laparoscopic approach under epidural anesthesia without endotracheal intubation. The hernia content of omentum was repositioned back into the abdominal cavity, and the diaphragmatic defect was repaired with composite mesh. Which indicated that non-intubated laparoscopic mesh repair via epidural anesthesia is reliable and satisfactory for MH.

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Percutaneous suturing technique and single-site umbilical laparoscopic repair of a Morgagni hernia: Review of three cases

Cited by 10 publications

References 20 publications

Laparoscopic Morgagni hernia repair in children: systematic review

Laparoscopic Morgagni hernia repair in children: systematic review

Laparoscopic Management in Morgagni Hernia - Short Series and Review of Literature

Non-intubated laparoscopic repair of giant Morgagni’s hernia for a young man

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