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Thoracoscopic surgery for congenital diaphragmatic hernia: a report of nine cases
1Surgical Department, National Hospital of Pediatrics, Hanoi, Vietnam. nipliem@hotmail.com
Insights
Thoracoscopic repair of congenital diaphragmatic hernia (CDH) is a safe and feasible technique for children. This minimally invasive approach results in good respiratory function and early recovery.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Minimally Invasive Surgery
Background:
- Congenital diaphragmatic hernia (CDH) is a serious condition requiring surgical intervention.
- Traditional open repair can be associated with significant morbidity.
Purpose of the Study:
- To detail the surgical technique for thoracoscopic CDH repair in pediatric patients.
- To evaluate the early outcomes of this minimally invasive approach.
Main Methods:
- Retrospective review of nine pediatric patients undergoing thoracoscopic CDH repair.
- Standardized thoracoscopic technique using trocars and CO2 insufflation.
- Hernia defect repair with non-absorbable sutures.
Main Results:
- Successful repair in all nine patients, with defects located on the left or right side.
- Mean operative time of 80 minutes.
- Early recovery observed: chest tubes removed on postoperative day 1, discharge on day 5, normal follow-up at 3 months.
Conclusions:
- Thoracoscopic repair of CDH is a feasible and safe option for pediatric patients, including neonates.
- The technique offers minimal trauma, leading to improved respiratory function and accelerated recovery.
Purpose:
To describe the surgical technique and early results of thoracoscopic repair of congenital diaphragmatic hernia (CDH) in children.
Materials And Methods:
A retrospective review was undertaken of patients with CDH who underwent thoracoscopic surgery in our institution over a period of 15 months. There were nine patients, five boys and four girls, ranging in age from 7 days to 8 years. All nine patients underwent surgery under general anaesthesia. Reduction of the hernia contents was carried out using one optical trocar and two operating trocars. Pleural insufflation with carbon dioxide was maintained at a pressure of 2 to 4 mmHg. The hernia defect was repaired using non-absorbable interrupted sutures.
Results:
The hernia was located on the left side in seven patients and on the right side in two. The mean operative time was 80 minutes. In all patients, the chest tube was removed on the first postoperative day. All patients were discharged on the fifth postoperative day. Chest X-ray and clinical examination 3 months after surgery were normal in all patients.
Conclusion:
The thoracoscopic approach for the repair of CDH in children, including small infants and newborns, is feasible and safe. The technique causes minimal trauma, results in good respiratory function, and promotes early recovery.
