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Laparoscopic repair of Morgagni's hernia: An innovative approach
Rasik S Shah1, Pradeep Chandra Sharma2, Deepraj S Bhandarkar2
1Department of Paediatric Surgery, P. D. Hinduja National Hospital and Medical Research Centre, Mahim, Mumbai, Maharashtra, India.
Aim:
To review our experience of laparoscopic repair of Morgagni's hernia (MH) using transfascial sutures.
Materials And Methods:
This is a retrospective review of patients presenting to the first author with the diagnosis of MH over a 15-year period. The variables analyzed included demographic data, clinical presentation, and operative details.
Results:
In all there were five male with a median age of 2 years. They were asymptomatic and MH was detected incidentally by observing an air-filled density in the right cardiophrenic angle on plain X-ray of the chest. Computed tomography (CT) confirmed the diagnosis in all patients. All patients underwent laparoscopic repair of MH using transfascial sutures. The average operative time was 75 min. Oral feeding was started 6 h after surgery and patients were discharged on either 3(rd) or 4(th) postoperative day. Postoperative follow-up X-ray confirmed the intact repair.
Conclusions:
Laparoscopic repair of MH using transfascial sutures is an easy and effective solution. Multiple horizontal mattress sutures taking full thickness of abdominal wall muscles with the edge of the diaphragm leads to a strong repair. As sutures are tied extracorporeally, the technique is easily reproducible.
