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Laparoscopic repair of traumatic diaphragmatic hernias
1Department of Surgery, University of Munich, Klinikum Grosshadern, Marchioninistrasse 15, 81377 München, Germany.
Background:
Traumatic diaphragmatic hernias are serious complications of blunt abdominal or thoracic trauma. In the early posttraumatic period, they are often missed, and they may be followed by a variety of subacute or chronic symptoms due to pulmonary or intestinal obstruction.
Methods:
We present three cases of traumatic diaphragmatic hernias. Two of them were successfully treated by laparoscopy and direct suturing during the early posttraumatic period; the other was treated 10 years after the trauma.
Results:
We found that laparoscopy is a safe, successful, and gentle procedure not only for diagnosis but for treatment as well. The postoperative course was uneventful in all cases. All patients remained asymptomatic during long-term follow-up (42-60 months). These results are promising. We expect the same good long-term results after laparoscopic repair as after open conventional surgery.
Conclusion:
We recommend that surgeons with sufficient experience in laparoscopy use a minimally invasive approach to treat chronic as well as acute traumatic diaphragmatic hernias in hemodynamically stable patients.
