Transthoracic repair of Morgagni’s hernia

Ambrogi, Vincenzo; Forcella, Daniele; Gatti, Antonio; Vanni, Gianluca; Mineo, Tommaso Claudio

doi:10.1007/s00464-006-9017-7

Cited by 35 publications

(16 citation statements)

References 14 publications

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“…Furthermore, trans-abdominal approaches allow for exclusion of hernia-associated intraabdominal pathologies or complications like strangulation and perforation [6,10]. Besides that, some authors advocate a transthoracic approach by providing better overview during dissection of the hernia sac from mediastinal, pleural and pulmonary structures [4,12]. Nevertheless, minimally-invasive trans-abdominal surgery by laparoscopy had been shown as being sufficient by providing good functional results, safe and feasible in hiatal hernia repair and, therefore, can be transferred to retrocostoxiphoid diaphragmatic hernia repair [13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Morgagni−Larrey diaphragmatic hernia repair in adult patients: a retrospective single-center experience

Oppelt

Askevold

Bender

et al. 2020

Hernia

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Purpose Morgagni−Larrey congenital diaphragmatic hernia (MLH) is rare in adult patients and surgery is performed infrequently. The evidence regarding the most beneficial treatment modality is low. Nevertheless, with increasing experience in minimally-invasive surgery, the literature proves the laparoscopic approach as being safely feasible. However, knowledge on the disease as well as treatment options are based on single surgeon's experiences and small case series in the literature. Methods Retrospective single-center analysis on adult patients (≥ 18 years) with MLH from 01/2003 to 06/2019 regarding symptoms, hernia sac contents, surgical technique and perioperative outcome. Results 4.0% of diaphragmatic hernia repair procedures were performed for MLH (n = 11 patients). 27.3% of these patients were asymptomatic. Dyspnea or gastrointestinal symptoms were frequently observed (both in 45.5% of the patients). Colon transversum (63.6%), omentum majus (45.5%) and/or stomach (27.3%) were the most common hernia sac contents. Correct diagnosis was achieved preoperatively in 10/11 patients by cross-sectional imaging. All procedures were performed by trans-abdominal surgery (laparotomy in four and laparoscopy in seven patients). All hernias were reinforced by mesh after primary closure. No differences were observed in the perioperative outcome between patients who underwent hernia repair by laparotomy versus laparoscopy. Pleural complications requiring drainage were the most common postoperative complications. Conclusion MLH repair seems to be safely feasible by laparoscopic surgery. The benefit of mesh augmentation in MLH repair is not clear yet. In contrast to the current literature, all patients in this study received mesh augmentation after primary closure of the hernia. This should be evaluated in larger patient cohorts with long-term follow-up.

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Section: Discussionmentioning

confidence: 99%

Morgagni−Larrey diaphragmatic hernia repair in adult patients: a retrospective single-center experience

Oppelt

Askevold

Bender

et al. 2020

Hernia

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“…The diaphragmatic defects sometimes do not have sufficient margin for reapproximation directly. Several surgeons reported using artificial material for closing large defect [13, 14]. In our case, the diaphragmatic defect was small (3 cm × 4 cm in size), so we perform primary closure of the diaphragmatic defect by thoracoscopic surgery alone, and we didn’t apply a mesh to reinforce the diaphragm.…”

Section: Discussionmentioning

confidence: 95%

Video-assisted thoracoscopic surgery for adult Bochdalek hernia: a case report

Shen

Jiao

Xiong

et al. 2016

J Cardiothorac Surg

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BackgroundBochdalek hernia is a type of congenital diaphragmatic hernia that typically presents in childhood, while this diseases is extremely rare in adults.Case presentationWe review a case of a 63-year-old man with a left-sided Bochdalek hernia who was experiencing occasional pain at the left side of his chest for 8 months. The diagnosis of Bochdalek hernia was made by chest computed tomography. A part of the retroperitoneal adipose tissue was herniated into the left thoracic cavity through the diaphragmatic defect. The hernia was treated via video-assisted thoracoscopic surgery and he made an uneventful recovery.ConclusionsWe report a rare case of a left-sided Bochdalek hernia for which our patient was treated successfully via video-assisted thoracoscopic surgery. Even though rare, this disorder should be recognised, examined and treated appropriately to avoid complications.

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“…Существует разница в оценках относительно преимуществ того или иного хирургического доступа при коррекции грыж слабых анатомических зон диафрагмы. Ряд авторов предпочитают трансторакальный [9,19,39,46,67] или трансабдоминальный [6,15,51,59,79] доступ, другие отстаивают эндоскопические вмешательства [24,36,60]. Трансабдоминальный доступ предпочтителен для большинства хирургов.…”

Section: Discussionunclassified

“…[48] при двустороннем метастатическом поражении легких. V. Ambrogi [9], обобщая 20-летний опыт использования трансторакального доступа, указывает на использование в последние годы торакоскопического доступа с ручной поддержкой из трансксифоидального доступа.…”

Section: Discussionunclassified