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Morgagni hernia repair in children: comparison of laparoscopic and open results
Carrie A Laituri1, Carissa L Garey, Daniel J Ostlie
1Department of Surgery, Children's Mercy Hospital, Kansas City, Missouri 64108, USA.
Insights
Laparoscopic repair of Morgagni hernias in children is effective and simple. This minimally invasive approach offers significant advantages over open surgery, with shorter hospital stays and no recurrence.
Area of Science:
- Pediatric surgery
- Surgical innovation
- Diaphragmatic defects
Background:
- Morgagni hernias are anteromedial diaphragmatic defects.
- These defects are often simpler to repair than posterolateral defects.
- Laparoscopic visualization of anterior defects is straightforward.
Purpose of the Study:
- To review the experience with laparoscopic and open repair of Morgagni hernias in children.
- To compare outcomes between laparoscopic and open surgical approaches.
- To evaluate the efficacy and safety of minimally invasive repair for pediatric Morgagni hernias.
Main Methods:
- Retrospective review of pediatric patients undergoing Morgagni hernia repair (January 1994 - May 2009).
- Comparison of outcomes between laparoscopic (n=9) and open (n=8) repair groups.
- Analysis of patient demographics, defect size, surgical techniques, and length of stay.
Main Results:
- No significant differences in age, weight, or defect size between laparoscopic and open groups.
- Laparoscopic repair resulted in a significantly shorter mean length of stay (1.1 days) compared to open repair (3.0 days).
- No intraoperative complications or recurrences were observed in either group.
Conclusions:
- Laparoscopic repair of Morgagni hernias in children is a safe and effective procedure.
- Minimally invasive surgery offers distinct advantages, including reduced hospital stay.
- The technique is well-suited for addressing anteromedial diaphragmatic defects in pediatric patients.
Introduction:
Morgagni hernias are anteromedial diaphragmatic defects that are typically simple to repair. As opposed to posterolateral defects, which are very difficult to expose laparoscopically, the anterior defects can be easily seen with this approach. We reviewed our experience with laparoscopic and open repair of Morgagni hernias in children and their associated outcomes.
Materials And Methods:
A retrospective review was conducted on all patients who underwent repair of Morgagni hernia from January 1994 to May 2009.
Results:
Seventeen patients were identified, of whom 9 underwent laparoscopic repair and 8 underwent an open repair. The mean age at operation was 3 years (newborn to 14 years) with a mean weight of 20.7 kg (3.6-87.6 kg). Intraoperatively, the diaphragmatic defect size in maximal dimension ranged from 3 to 11 cm. There was no difference in the average age, weight, and defect size among both groups. Of those who underwent laparoscopic hernia repair, 5 patients were closed with a Surgisis-Gold (SIS) patch, 1 was closed primarily with interrupted sutures, and 3 were closed with transabdominal sutures. In the open group, 7 were closed primarily and 1 required SIS patch for closure. Mean length of stay was 3.0 ± 1.5 days in the open group compared with 1.1 ± 0.4 days in the laparoscopic group (P < 0.01). There were no intraoperative complications and no recurrences.
Conclusions:
Laparoscopic repair of Morgagni hernias is a relatively simple and effective method of repair in children with accentuated advantages of minimally invasive surgery.
