Modified Thoracoabdominal Approach for the Repair of Massive Diaphragmatic Hernias

Various approaches to treat large diaphragmatic hernias in adults are available depending on the extent of herniation, patient stability, and surgeon experience. We present a 2-case series of massive diaphragmatic hernia repairs using a modified thoracoabdominal technique whereby a stabilizing myocutaneous bridge is left between the thoracotomy and laparotomy incisions. This technique maintains excellent exposure, may be accomplished for either right- or left-sided hernias, and spares a portion of unaffected diaphragm.