Laparoscopic Transabdominal Preperitoneal Repair of a Hernia of Morgagni

Abstract

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.

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

“…Figure 4 is an example of a postoperative chest X-ray showing a fluid collection within the unexcised hernia sac. Many authors feel the hernia sac should not be resected [12,19,80,81]. In children, dissection of the peritoneal sac has resulted in fatal cases of pneumopericardium [82].…”

“…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.…”

Technical standardization of laparoscopic repair of Morgagni diaphragmatic hernia in children: results of a multicentric survey on 43 patients

“…In the last 15-years with the advent of laparoscopic surgery, several cases underwent laparoscopic repair which have been reported in the surgical literature both in adults and children [4][5][6][7][8][9][10]. Due to the rarity of this condition, there is no consensus about the gold standard laparoscopic technique to be adopted and various approaches have been reported until now [11][12][13].The aim of this study is to evaluate the surgical and clinical outcomes of children who underwent laparoscopic correction of CMDH in 8 international centers of pediatric surgery, in order to standardize the surgical correction technique of this rare pathology.…”

Congenital herniation through the foramen Morgagni — clinical presentation, diagnosis and treatment in pediatric population

“…The use of prosthetic mesh is becoming more popular, especially if the defect is large. Mesh overlapping the edges of the defect provides a good tension-free repair, even used laparoscopically [14,15].…”