Primary thoracoscopic repair of diaphragmatic hernia with pericostal sutures

The surgical management of congenital diaphragmatic hernias has traditionally been via laparotomy or thoracotomy. Although laparoscopic and thoracoscopic repairs have been described, most reports are in older infants. We describe a method for primary thoracoscopic repair applied in the immediate neonatal period when no posterolateral rim of diaphragm exists. This simple technique for placing the pericostal sutures is a useful adjunct in the thoracoscopic management of diaphragmatic hernias.