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Laparoscopic Repair of Morgagni Hernia in Children
Cetin Ali Karadag1, Basak Erginel2, Abdullah Yildiz1
1Sisli Hamidiye Etfal Training and Research Hospital, Department of Pediatric Surgery, Istanbul, Turkey.
Purpose:
This study aimed to evaluate our patients who underwent laparoscopic-assisted transabdominal repair for Morgagni hernia (MH).
Methods:
We retrospectively reviewed patients who underwent laparoscopy-assisted transabdominal repair using loop sutures for MH between March 2010 and April 2021. Demographic data, symptoms, operative findings, operation methods, and postoperative complications of the patients were reviewed.
Results:
A total of 22 patients with MH were treated with laparoscopy-assisted transabdominal repair using loop suture. There were 6 girls (27.2%) and 16 boys (72.7%). Two patients had Down syndrome, and two patients had cardiac defects (secundum atrial septal defect, patent foramen ovale). One patient had a V-P shunt due to hydrocephalus. One patient had cerebral palsy. The mean operation time was 45 min (30-86 min). The hernia sac was not removed, and a patch was not used in any of the patients. The mean hospitalization time was 1.7 days (1-5 days). One patient's defect was very large, and another patient's liver was densely attached to the liver sac, causing bleeding during dissection. In total, two patients were converted to open surgery. There was no recurrence during the follow-up.
Conclusion:
Laparoscopy-assisted transabdominal repair is an efficient and safe choice for the repair of MH. Leaving the hernia sac does not increase the recurrence, so there is no need to dissect the sac.
Insights
Laparoscopic repair of Morgagni hernia (MH) using loop sutures is safe and effective. This approach avoids hernia sac dissection, reducing recurrence risk and hospitalization time for pediatric patients.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Thoracic Surgery
Background:
- Morgagni hernia (MH) is a rare congenital diaphragmatic hernia.
- Surgical repair is indicated for symptomatic MH.
- Laparoscopic approaches offer potential benefits over open surgery.
Purpose of the Study:
- To evaluate the efficacy and safety of laparoscopic-assisted transabdominal repair for Morgagni hernia (MH).
- To assess the outcomes of using loop sutures without hernia sac dissection.
- To determine the recurrence rate and complication profile of this technique.
Main Methods:
- Retrospective review of 22 patients with MH undergoing laparoscopic-assisted transabdominal repair with loop sutures (March 2010 - April 2021).
- Analysis of demographic data, symptoms, operative findings, surgical methods, and postoperative complications.
- Comparison of operative time, hospitalization duration, and recurrence rates.
Main Results:
- 22 patients (6 female, 16 male) underwent the procedure.
- Mean operative time was 45 minutes; mean hospitalization was 1.7 days.
- No recurrence was observed during follow-up; two patients required conversion to open surgery due to large defects or adhesions.
Conclusions:
- Laparoscopic-assisted transabdominal repair is an efficient and safe option for MH.
- Hernia sac dissection is unnecessary and does not increase recurrence rates.
- This minimally invasive technique offers favorable outcomes for Morgagni hernia repair.
