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Nitinkumar Bhajandas Borkar et al

by reducing the contents and repairing the defect, the 2. Van der Zee DC, Bax NM. Laparoscopic repair of congenital
causative factor was gone and the stomach was restored to diaphragmatic hernia in a 6-month-old child. Surg Endosc
1995 Sep;9(9):1001-03.
its normal anatomic confines. However, we are unable to 3. Berti A. Singolare attortigliamento dell esofago colduodeno
recommend omitting gastropexy based on a single case. seguito da rapido morte. Gazz Med 1866. Ital 9:136.
Perhaps more anatomical studies could throw light on this 4. Borchardt M. Zur Pathologic und therapie des magen volvulus.
aspect of the treatment. Arch Klin Chir 1904;74:243-60.
Usual minimal invasive approach to diaphragmatic 5. Berman L, Stringer DA, Ein S, Shandling B. Childhood
hernia is thoracoscopic. We chose to do laparoscopy because diaphragmatic hernias presenting after the neonatal period.
Clin Radiol 1988 May;39(3):237-44.
we are more familiar with this approach. We do open repair 6. Cameron AE, Howard ER. Gastric volvulus in childhood.
also by abdominal route. Also, it is more useful to detect J Pediatr Surg 1987 Oct;22(10):944-47.
and treat abnormalities of gut position. The mobilization of
the left lobe of liver (especially if it forms a part of the ABOUT THE AUTHORS
contents) is also easier through the laparoscopic approach.
The posterior lip of the defect is better defined after incising Nitinkumar Bhajandas Borkar
the overlying posterior peritoneum. This incision, we Assistant Professor, Department of Surgery, Acharya Vinoba Bhave
believe, is easier and well controlled, if performed Rural Hospital, Wardha, Maharashtra, India
laparoscopically. We feel that the choice of the approach
should depend upon the surgeon’s preference, anatomical Nitin Pant
defect and associated problems. Senior Resident, Department of Pediatric Surgery, Maulana Azad
Medical College, New Delhi, India
REFERENCES
Satish Kumar Aggarwal
1. Miller DL, Pasquale MD, Seneca RP, Hodin E. Gastric volvulus
in the pediatric population. Arch Surg 1991 Sep;126(9): Professor, Department of Pediatric Surgery, Maulana Azad Medical
1146-49. College, New Delhi, India, e-mail: satish.childurology@gmail.com

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