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Laparoscopic Morgani hernia repair in infant with sutures and Ethicon Secure Strap device.

Medhat Ibrahim, MD. Al-Azhar University, Naser City, Cairo, Egypt

Purpose: Morgagni hernia (MH) is a rare condition.MH is less than 6% of surgically treated diaphragmatic hernias in infants. There is no specific symptom for the Maorgagni hernia. Open surgical repair was the golden stander before the introduction of the laparoscopic surgery in the children and infant. There are many different laparoscopic techniques for MH repair have been reported.

I report laparoscopic repair of MH in five infants using primary sutures closure with inrta-corporeal knot tying and Ethicon secure strap device. This study is an evaluation of the safety and efficacy of this new laparoscopic technique of MH repair in infants with it is short-term outcomes follow up. Patients and methods: Five infants with MHs underwent laparoscopic repair by hernia sac excision then two primary sutures, non-absorbable proline through the full thickness of the anterior abdominal wall and the posterior rim of the defect, intra corporeal sutures knot tying, Ethicon secure strap device which was used to complete the colures of the defect. there was no insertion of chest tube or drain.

Results: Five infants with MH were operated upon. There were 4 males and 1 female. All cases were left side MH, Male-female ratio was 4:1. Intraoperative and postoperative analgesia requirement was Minimal (Paracetamole 100mg /kg/rectal suppository/12 hours for the first 24 hours). Ceftriaxone 50 mg/kg single dose at the anesthesia induction. All operations were completed laparoscopic. All infants started and tolerated oral regular feeding with in 24 hours from surgery.

None of the patients developed intraoperative or postoperative complications. The maximum follow-up was 36months (mean, 17 months). All patients are in good health without recurrence or port site compilation.

Conclusion: This easy save technique of MH repair is reducing the operative time and postoperative hospital stay. it is minims the need of postoperative analgesia, anti biotic. The early oral feeding is also a good benefit.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 87323

Program Number: P718

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

55

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