Robin B Osofsky, MD, Cyril Kamya, MD, Louis Melendez, Rodrigo Rodriguez, MD, Edward Auyang, MD. University of New Mexico, Department of Surgery
Morgagni-Larrey Hernia is an anteromedial type of congenital diaphragmatic hernia (CDH). They were first described by Morgagni in 1760 and later characterized by Larrey in 1829. It is the least common type of CDH and has a left side predominance (80%). Most are asymptomatic and do not present until adulthood. Repair can be performed via a thorascopic or laparoscopic approach as primary or with mesh. The following is a case report video abstract demonstrating a laparoscopic morgagni hernia repair.
The patient is a 43-year-old female with history of chronic, dull, non-radiating upper abdominal pain with associated constipation, nausea, and emesis. She had a past medical history significant for pancreatitis, bipolar disorder, tobacco use, previous methamphetamine and opiate abuse for which she was on Suboxone. Preoperative CT demonstrated an anteromedial diaphragmatic hernia containing transverse colon and omentum. After preoperative evaluation and clearance patient was scheduled for an elective laparoscopic diaphragmatic hernia repair.
Patient was placed in the supine, split leg, and arms tucked position. Veress entry was employed for access. Hernia was successfully reduced and repair primarily with braided polyester suture. Operative time was 195 minutes EBL was 300 cc. Specimens included omentum and hernia sac.
Postoperatively patient was started on a regular diet. Acute pain was consulted on postoperative day one as patient had history of opiate abuse and current suboxone use. Patient was subsequently transitioned to PO pain medications and discharge home on postoperative day 3 . On patient’s one month postoperative visit patient had resolved postoperative pain and resolution of preoperative symptoms of nausea, emesis, and constipation.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94822
Program Number: V231
Presentation Session: Video Loop Day 2
Presentation Type: VideoLoop