World Journal of Laparoscopic Surgery

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VOLUME 18 , ISSUE 1 ( January-April, 2025 ) > List of Articles

Original Article

Laparoscopic Repair of Congenital Diaphragmatic Hernia in Adults: A Tertiary Care Center Two-year Experience with Literature Review

Dhananjay Pandey, Vijender Verma, Lakshmi Kona

Keywords : Bochdalek hernia, Congenital diaphragmatic hernias, Diaphragmatic hernia, Morgagni hernia, Tertiary care center

Citation Information : Pandey D, Verma V, Kona L. Laparoscopic Repair of Congenital Diaphragmatic Hernia in Adults: A Tertiary Care Center Two-year Experience with Literature Review. World J Lap Surg 2025; 18 (1):20-25.

DOI: 10.5005/jp-journals-10033-1645

License: CC BY-NC 4.0

Published Online: 16-12-2024

Copyright Statement:  Copyright © 2025; The Author(s).


Abstract

Aims and background: Surgical repair of diaphragmatic hernia (DH) is indicated in all diagnosed cases. It can be done by various approaches. Traditionally, laparotomy has been preferred, but with increasing experience in laparoscopic techniques advanced laparoscopic procedures are being carried out as well. Materials and methods: We retrospectively reviewed the clinical records of confirmed cases of DH treated in our institute from April 2016 to March 2018 with a minimum follow-up of 3 years. Cases of hiatus hernias have been excluded. The diagnosis was confirmed in all cases radiologically. Surgical repair was done in all cases by laparoscopic approach. Results: Laparoscopic repair was completed successfully in all patients with none requiring conversion. All patients except one were male (Male:Female – 6:1). Median age in our series of patients was 42 years. Predominant symptoms were abdominal discomfort with one patient being asymptomatic. Eventration was present in two of the patients, both being on the left side, while Bochdalek's hernia was noted in two patients. Three patients had anterior parasternal hernia with one being Morgagni and Larry's hernia each and in one patient bilateral anterior hernia was present. Diagnosis made in all preoperatively except Larry's hernia that was detected intraoperatively. Content comprised of stomach, part of small and large bowel, omentum, appendix, spleen, tail of pancreas and left kidney. Mesh repair was done in all cases except Larry's hernia where anatomical repair of defect was done. Operative time ranged from 50 to 90 minutes. Postoperative recovery was smooth in all. Hospital stay was 2–4 days. Follow-up has ranged from 45 to 68 months that has been uneventful till date without any recurrence reported. Conclusion: Surgical repair of DH should be done in all diagnosed patients irrespective of symptoms. The laparoscopic approach is recommended, keeping in view better vision, lesser postoperative pain, shorter hospital stay, and quicker recovery with the equivalent outcome. Clinical significance: Congenital diaphragmatic hernias (CDH) are mainly present in the neonatal period and are associated with high mortality. Rarely, these hernias are present later in life in adulthood. Late-presenting CDH is often difficult to diagnose and delays in treatment are common. In this article, we share our experience of diagnosing and managing CDH in adult patients.


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