Laparoscopic Repair Of Morgagni-Larrey Hernias

Jeffrey N Harr, MD, MPH, Fred Brody, MD, MBA. The George Washington University

Introduction:

Morgagni-Larrey hernias are a defect of the anterior diaphragm within the sternocostal triangle. These hernias are rare and comprise less than 5% of all diaphragmatic hernias. Bilateral Morgagni-Larrey hernias are exceptionally rare. Most are diagnosed in the 5th decade of life, and a majority of patients are symptomatic with pulmonary complaints being the most common.

Methods:

We report two cases of Morgagni-Larrey hernias. The first is a 53-year old asymptomatic gentleman with a right-sided hernia. The second is an 84-year old symptomatic woman with a rare bilateral Morgagni-Larrey hernia. Both hernias were repaired laparoscopically. The defects were primarily closed and buttressed with mesh.

Results:

Both patients had an uncomplicated hospital course, and were discharged on post-operative day 2. They remain asymptomatic at 1 year, and a follow-up CT scan demonstrated no evidence of recurrence.

Conclusion:

A laparoscopic approach provides optimal visualization, and allows for a rapid recovery compared to traditional open abdominal and thoracic approaches. Furthermore, a laparoscopic approach with a primary closure and mesh buttress provides an effective and durable repair.

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