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Laparoscopic repair of Morgagni Diaphragmatic Hernia
Laparoscopic repair of a Morgagni hernia
Shiv Bhandari, Harriett Mitchell, Ewen A Griffiths
Aim: In this DVD we aim to present a technique to repair a rare type of diaphragmatic hernia. Morgagni hernia only account for approximately 2% of congenital diaphragmatic hernias. Herniation is through the foramen of Morgagni, which lies in the retrosternal area between the sternal and costal attachments of the diaphragm.
Methods: This video demonstrates the operative repair in a case of Morgagni hernia in a 73 year old female presenting with shortnesss of breath on mild exertion. A diagnosis of Morgagni hernia was made following plain film and CT imaging of the thorax.
Results: Surgical repair of a Morgagni hernia via a laparoscopic approach is shown. The hernia is fully reduced following adhesiolysis and the defects are closed using multiple trans-abdominal sutures. A synthetic dual layer mesh is used to reinforce the repair.
Conclusion: Laparoscopic repair of a Morgagni hernia is feasible. The patient is now symptom free and routine chest X-ray in the outpatient department at 8 weeks post-op showed no early recurrence.
The operation can also be performed using a open technique; for example in this case report which is freely accessible:
Surgical treatment of a Morgagni hernia causing intermittent gastric outlet obstruction.cGriffiths EA, Ellis A, Mohamed A, Tam E, Ball CS. BMJ Case Rep. 2010 Nov 5;2010
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