Robot-Assisted Diaphragmatic Plication in an Adult Bochdalek Hernia With Intrathoracic Hepatic Displacement

We report the case of a 72-year-old woman with a 9-month history of dyspnea and impaired gas exchange. The patient had significant cardiac comorbidities. Computed tomography imaging revealed right diaphragmatic elevation with intrathoracic displacement of the liver (in a 90° angle). A robot-assisted diaphragmatic plication was performed. Intraoperative contrast-enhanced ultrasound was performed to rule out hepatic torsion and confirmed preserved perfusion. This case underscores the importance of accurate diagnosis and multidisciplinary planning in adult Bochdalek hernia with hepatic herniation. Robot-assisted repair with perfusion monitoring was found to be safe and effective.