Laparoscopic Treatment of Morgagni-Larrey Hernia: Technical Details and Report of a Series

Abstract

Three patients with Morgagni-Larrey hernia were admitted to the surgical department between August 2000 and September 2003 with slight chest pain and dyspnea. Laparoscopic repair of the diaphragmatic hernia was performed using a tension-free closure of the defects with either Vicryl-Prolene or dual facing mesh fixed by Prolene extracorporeal knots and Endostitch devices. The patients were discharged on postoperative day 5 without complications. Mean follow-up has been 23 months (range, 15-36 months) and no recurrence or morbidity related to the procedure has been seen. Laparoscopic repair of Morgagni-Larrey hernia represents an attractive alternative to open surgery. The benefits are gentle and easy manipulation of the content of the sac, reduced surgical trauma, and rapid and uneventful recovery.

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

“…Others recommend using mesh repairs in all cases except those involving neonates [88]. Several different types of materials have been used: polypropylene, expanded polytetrafluoroethylene (ePTFE) (dual mesh; Gore Medical, Flagstaff, AZ, USA), Vypro (Vypro II, Ethicon Endosurgery, Cincinnati, OH, USA), Composix (C. R. Bard, Inc, NJ, USA), bovine pericardium (Tutopatch; Tutogen Medical, Neunkirchen, Bavaria, DE, USA), and Parietex (Parietex Composite; Sofradim, Trevoux, France), to name a few [29,68,[89][90][91][92]. Another technique used by several authors to avoid cyst formation is to leave a drain in the hernia sac [24,60,72,79,84,93].…”

“…Management of the hernia sac has already been discussed. Based on the opinions of several authors, achieving at least 1.5 to 2.5 cm overlap of the mesh is preferred [89,91,92]. Of those authors who have used polypropylene mesh to repair the defect, 29% (5/17) do not cover the mesh [25,72,95] because they think the round ligament, liver, and omentum provide ample protection for the bowel [12,70].…”

Laparoscopic repair of adult diaphragmatic hernias and eventration with primary sutured closure and prosthetic reinforcement: a retrospective study

“…Sac dissection is cumbersome, time consuming, and associated with a high risk of pleural injury [16]. With Morgagni hernias, there is the added danger of injury to the superior epigastric vessels during dissection of the sac [17,18].…”

Paraesophageal Hernia as a Cause of Chronic Asymptomatic Anemia in a 6 Years Old Boy; Case Report and Review of the Literature

“…Another important parameter of relapse is a short esophagus, which results in a technically difficult performance of fundoplication. In this cases, Collis-Nissen procedure is preferred (27).…”