The application of the percutaneous suturing technique in thoracoscopic repair of congenital diaphragmatic hernia

Purpose: To describe a minimally invasive technique with primary closure and strong suture connection that is feasible in cases of larger, most common type B defects of congenital diaphragmatic hernia (CDH). Background: The thoracoscopic approach (TA) is a favorable technique for the repair of CDH and is still evolving globally. A common issue is finding the optimal suture technique for secure closure in order to prevent recurrences. Whether a defect can be closed only by sutures or by using a patch depends on the size of CDH, the presence of a muscular rim along the inner thoracic surface and finally on the surgeon’s experience. From a geometrical point of view, the challenge is to transform the circular defect into a line, without tension, with a strong compound and preferably without additional material. To address this, we apply a setting of the sutures in a “T-shape” and a way to lead the sutures around the rib bones in order to increase stability. This method allows for the primary closure of CDHs and also applies to larger defects. Cases: We present seven newborns with posterolateral CDH on the left side. The defects were solely repaired by TA and by the suturing technique described in detail.

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“…A noteworthy report was published in 2020 by Bogusz et al [ 13 ]. They describe an adapted method of percutaneous internal ring suturing (PIRS).…”

Section: Discussionmentioning

confidence: 99%

Thoracoscopic Guided Pericostal Sutures as a Solid Fixation for Primary Closure of Congenital Diaphragmatic Hernias

et al. 2022

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Tension-free thoracoscopic repair of congenital diaphragmatic hernia combined with a percutaneous extracorporeal closure technique: how to do it

et al. 2022

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Surgeon level variation in outcome of repair of congenital diaphragmatic hernia with particular reference to the management of recurrence

Tamura

O’Connor

Jaffray

2021

Journal of Pediatric Surgery

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The application of the percutaneous suturing technique in thoracoscopic repair of congenital diaphragmatic hernia

Cited by 4 publications

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Thoracoscopic Guided Pericostal Sutures as a Solid Fixation for Primary Closure of Congenital Diaphragmatic Hernias

Thoracoscopic Guided Pericostal Sutures as a Solid Fixation for Primary Closure of Congenital Diaphragmatic Hernias

Tension-free thoracoscopic repair of congenital diaphragmatic hernia combined with a percutaneous extracorporeal closure technique: how to do it

Surgeon level variation in outcome of repair of congenital diaphragmatic hernia with particular reference to the management of recurrence

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