“…Furthermore, Hassan et al (13) choose to leave the hernia sac in-situ to avoid the risk of pneumomediastinum and injury to thoracic structures. Although some authors prefer the excision of the sac especially as it decreases the rate of morbidity as the fluid collection and reduces the tissue trauma, because the sac is manipulated instead of the content (4).Monsivais et al, (12) used single-incision laparoscopic port with adequate reduction of the hernia, excision of the sac, and applying mesh over the diaphragmatic defect from 2 cm incision.…”