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Minimally invasive procedure for hemorrhoids is one of the commonest new wave operations done for prolapsed hemorrhoids. The diameter of the stapled tissue is critical in this operation, and an increase in the same could include more tissue in the anvil, with disastrous results. This is a case report of a post minimally invasive procedure for hemorrhoids bleed, which was refractory to two local oversewing attempts. When the bleeding was massive, an angiogram was obtained. This revealed a pseudo aneurysm of the left superior haemorrhoidal artery, which was embolized, stopping the bleed. The stapler dimensions were studied and the possible cause of the event was arrived at. The specific stapler used had a diameter of 2 mm more than the regular Medtronic and Ethicon staplers, possibly including more of the rectal wall, and the superior haemorrhoidal artery as well. This case report documents a rare and potentially fatal complication of a simple procedure.

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In 1769, Morgagni described the diaphragmatic hernia carrying his name, whist doing a post mortem on a head injury patient. Independently, Larrey had described a left-sided Banterior sternoscostal^hernia, and so left-sided Morgagni hernia is also known as a Larrey hernia. It is a very rare type of congenital diaphragmatic hernia with an incidence of 1-3%. It is caused by failure of fusion in the anterior portion of the pleuroperitoneal membrane resulting in retrosternal defect in the diaphragm. Although infants present with recurrent respiratory infections, they can often go unnoticed for several decades. In this case report, we present a 48-year-old male, diagnosed with Larrey hernia who underwent successful total laparoscopic suture repair and Meshplasty. The sac contents were reduced, and the sac was not excised. The edges were approximated, and the mesh was placed to widely cover the defect and suture to the abdominal wall all around. Relevant literature and technical considerations are discussed in this article.

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