Laparoscopic repair of a Morgagni hernia

Abstract

Morgagni hernias are unusual diaphragmatic hernias which usually present in adulthood. They have traditionally been repaired through transabdominal or transthoracic approaches. The authors present a case of a laparoscopic repair of a Morgagni hernia in a 52-year-old female. A tension free repair of the defect was accomplished utilizing Goretex (W.L. Gore & Associates, Inc., North Elkton, MD) mesh. The patient had an uneventful recovery and is asymptomatic at 6 months follow-up. The etiology, diagnosis and traditional surgical approaches to this problem are discussed. A technique for laparoscopic repair of a Morgagni hernia is described. The literature on the laparoscopic repair of a Morgagni hernia is reviewed and different operative techniques are discussed.

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

“…Cholecystectomy, Nissen fundoplication, paraesophageal hernia repair, gastrectomy, abdominal aortic aneurysm repair, and coronary artery bypass graft (CABG) have been performed simultaneously with MH repair [17,61,[72][73][74][75][76]. Successful repair during pregnancy also has been reported.…”

Pericardial Effusion Can Be a Critical Complication After Laparoscopic Hernia Repair Using Mesh and Stapler for Morgagni Hernia

“…12 Horton reviewed 298 cases of Morgagni hernias and reported that the advantages of laparoscopic repair were less postoperative pain, shorter hospital stays, and fewer complications. 15,16 These complications, which occurred in 17% of laparotomies, in 6% of thoracotomies, in 5% of laparoscopies, and in 0% of thoracoscopies, included pneumonia, arrhythmias, pneumothorax, wound infections, and pleural effusions except of pericardial effusion. Complications occurred in only two cases, and there was no recurrence of the hernia after the laparoscopic surgery.…”

Simultaneous laparoscopic management of Morgagni hernia and cholelithiasis: two case reports

“…Though in the literature, no patients with primary repair have had recurrences, still no long-term clinical or radiological follow-up has been recorded in these studies. Prostheses have been used in most cases, but again there is no uniformity; meshes used have included polypropylene mesh, and recent composite prostheses such as ePTFE (expanded polytetrafluoroethylene) mesh, porcine small intestine submucosa biocompatible prosthesis, parietex bilayered composite mesh and PVDF (polyvinylidene fluoride) mesh [ 11 – 14 ]. However, we decided to use polypropylene mesh, because of cost factor; and reperitonealization is generally not required as after the division of the falciform ligament, the liver comes to lie under the mesh and the chance of the mesh to adhere to hollow viscus is low.…”