Minhao Zhou, MD, John J Kelly, MD. UMass Memorial Medical Center
Morgagni hernia is a rare congenital diaphragmatic hernia with a variety of surgical approaches to repair both transthoracic and transabdominal. We present a video of our laparoscopic approach.
Methods and Procedures
A 37 year old obese female presents with 2 year history of worsening shortness of breath. Imaging evaluation revealed a large Morgagni hernia replacing a majority of her right lung. A laparoscopic repair was performed. The hernia contents containing omentum and colon were easily reduced with gentle traction. The hernia sac was dissected free with mostly blunt dissection and resected. Transfacial non-absorbable sutures were used to close the hernia defect. A tissue excluding synthetic mesh was sutured and tacked in place to strengthen the repair.
The patient tolerated the operation well and was discharged home on post operative day 2 without complications. Her shortness of breath resolved. Intraoperative view 6 month post operative when the patient returned for her laparoscopic gastric bypass showed intact repair with only omental adhesions to the mesh.
Laparoscopic Morgagni hernia repair is a viable and perhaps preferred approach because of all the benefits of minimally invasive surgery.
Program Number: V070