A hernia of Morgagni was successfully repaired laparoscopically by reducing the hernia, mobilizing the peritoneum around the perimeter of the defect, and stapling polypropylene mesh onto the surrounding fascia. This type of repair is technically easy and should give a high probability of success.

LPHR is safe, effective, and compares favorably to historical series of open paraesophageal hernia repair.

The use of mechanical stapling devices in endoscopic surgery has become widespread and commonplace. Although problems have been identified with these, to our knowledge no description has been made of retained, free intraperitoneal staples causing significant morbidity. We describe the case of a patient who underwent laparoscopically assisted vaginal hysterectomy. Four weeks postoperatively she developed a mechanical small-bowel obstruction which was caused by a free intraperitoneal staple creating an obstructing band. The obstruction was relieved laparoscopically. We believe that while retained free intraperitoneal staples are generally of no clinical consequence, surgeons should be aware that the potential exists for significant morbidity.

Techniques for reducing the incidence of small bowel obstruction following stapled LAVH include minimizing staple spillage and careful inspection of the adnexal staple line for partially formed staples.