Laparoscopic Repair of Peritoneopericardial diaphragmatic Hernia Repair

Shintaro Chiba, MD, Jana Lewis, MD, Igor Brichkov, MD, Danny Sherwinter, MD. Maimonides Medical Center

This is a case of a 60-year-old female with a significant surgical history of a trans-diaphragmatic cardiac ablation for atrial fibrillation 9 months prior, who presented to the emergency room with shortness of breath. A CT scan of the chest was obtained which showed the greater omentum and portions of the transverse colon extending from the abdomen into the pericardium through a peritoneopericardial diaghragmatic hernia. The patient was taken to the operating room for a laparoscopic repair of this hernia. Using gentle tension and lysis of adhesions, the transverse colon was dissected out of the hernia sac. The defect in the diaphragm was repaired with a Gore Dualmesh. No post-operative complications were observed and the patient was discharged on postoperative day 2. At 2 week follow up, the patient reported resolution of the shortness of breath. This is the first documented case of a laparoscopic repair of a peritoneopericardial diaghragmatic hernia.

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