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Two Trocar Laparoscopic Repair of Morgagni Hernia in Infant and Childhood: Simplified Technique

muscles with the anterior rim of the diaphragmatic defect 4. Contini S, Dalla Valle R, Bonati L, Zinicola R. Laparoscopic
and provides a tension free strong repair with minimal port repair of a Morgagni hernia: Report of a case and review of the
literature. J Laparoendosc Adv Surg Tech 1999;9:93-99.
site and good cosmetic outcome. 5. Fell SC. Surgical anatomy of the diaphragm and phrenic nerve.
The excision of the hernial sac is controversial. Some Chest Surg Clin N Am 1998;8:281-94.
15
advice hernial sac excision while other does not. The 6. Lima M, Domini M, Libri M, et al. Laparoscopic repair of
cavity obliteration was the same with nonexcised cases. 10 Morgagni-Larrey hernia in child. J Pediatr Surg 2000;35:
1266-68.
In these study only three cases, hernial sac was excised as it 7. Fernandez Cebrian JM, De Oteyza JP. Laparoscopic repair of
comes to the abdominal cavity during the reduction of the hernia of foramen of Morgagni: A new case report. J Laparoendosc
content. There was no bleeding with hernial sac excision Surg 1996;6:61-64.
by harmonic tissue dissector. It was increasing the operative 8. Ramachandran CS, Arora V. Laparoscopic transabdominal
time. Farther more, I did not insert chest tube or chest repair of hernia of Morgagni-Larrey. Surg Laparosc Endosc
Precut Tech 1999;9:358-61.
drain in all cases. The chest X-ray was normal all over the 9. Azzie G, Maoate K, Beasley S, et al. A simple technique of
follow-up period. Traditionally, other studies which use laparoscopic full-thickness anterior abdominal wall repair of
standard surgical procedures for the repair of MH, require retrosternal (Morgagni) hernias. J Pediatr Surg 2003;38:768-70.
a laparotomy which need more anesthetic, analgesic 10. Mallick MS, Alqahtani A. Laparoscopic-assisted repair of
Morgagni hernia in children. J Pediat Surg 2009;44:1621-24.
intervention and delayed recovery. The patient not only get 11. Hussong RL Jr, Landreneau RJ, Colo FH Jr. Diagnosis and repair
benefit from the minimally invasive approach, early of Morgagni hernia. Ann Thorac Surg 1997;63:1474-75.
recovery from major surgery and minimal scaring, but also, 12. Danielson PD, Chandler NM. Single-port laparoscopic repair
abdominal exploration and detection of associated intra- of a Morgagni diaphragmatichernia in a pediatric patient:
abdominal anomalies. Advancement in single-port technology allows effective
intracorporeal suturing. J Pediatr Surg 2010;45:E21-E24.
13. Van De Winkel N, De Vogelaere K, De Backer A, Delvaux G.
CONCLUSION Laparoscopic repair of diaphragmatic Morgagni hernia in

This easy and save technique of MH repair is reducing the children: Review of 3 cases. J Pediatr Surg 2011;46:E23-E26.
operative time, anesthetic, analgesic requirement and 14. Korkmaz M, Guvenc BH, Senel U. Minimal access surgical
repair of Morgagni hernia: The fate of the unresected hernia
postoperative hospital stay. There is not effect of excision sac. J Laparoendosc Adv Surg Tech 2007;17:833-36.
of hernial sac on the outcome of surgery. 15. Taha A, Radi E, Djamal O. Laparoscopic repair of Morgagni
diaphragmatic hernia in infants and children: Do we need to
REFERENCES resect the hernia sac? Annals Pediatr Surg 2012 Jan;8(1):1-4.

1. Cullen ML, Klain MD, Phillipart Al. Congenital diaphragmatic
hernia. Surg Clin North Am 1985;65:1115-38. ABOUT THE AUTHOR
2. Akhavan-Heidari M, Edwards D, Besenhaver J, Wolfer R. Medhat M Ibrahim
Incidental finding of congenital thoracic malformations in adult
population. South Med J 2006;99:539-43. Assistant Professor, Department of Pediatric Surgery, Faculty of
3. Rogers FB, Rebuck JA. Case report: Morgagni hernia. Hernia Medicine, Al-Azhar University, Nasr city, Cairo, Egypt, e-mail:
2006;10:90-92. medhat.ibrahim.elsayed@gmail.com

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