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Pediatric Surgery International

, Volume 21, Issue 10, pp 806–808 | Cite as

Thoracoscopic repair of congenital diaphragmatic hernia by inflation-assisted bowel reduction, in a resuscitated neonate: a better access?

  • K. SchaarschmidtEmail author
  • J. Strauß
  • A. Kolberg-Schwerdt
  • M. Lempe
  • F. Schlesinger
  • U. Jaeschke
Original Article

Abstract

Elective endoscopic diaphragmatic hernia repairs have been reported. But endoscopic surgery was regarded unsuitable for emergency repair of diaphragmatic hernia in ventilated newborn children in bad general condition. We report a new method for inflation-assisted reduction and thoracoscopic repair of congenital diaphragmatic hernia diaphragmatic in a vitally endangered neonate. From three 2.7 mm to 5 mm accesses warmed low-pressure, low-volume CO2 was inflated into the thorax at 100 ml/min and 2 mm mercury. This allowed spontaneous reduction of the thoracic viscera into the abdomen and diaphragmatic suture with minimal handling. The 65-min procedure was tolerated well without perioperative deterioration. The baby was weaned off the respirator and breast-fed within 2 days, mediastinal shift normalized in 6 days. In suitable infants thoracoscopic repair and inflation-assisted reduction of thoracic contents is a more physiological access to congenital diaphragmatic hernia than laparoscopy or laparotomy.

Keywords

Congenital diaphragmatic hernia Thoracoscopic Resuscitation Neonate Endoscopic surgery 

Notes

Acknowledgements

Support by Sonnenfeld Stiftung and Mickey foundation, Berlin, Mc Donald’s–Kinderhilfe, Munich

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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • K. Schaarschmidt
    • 1
    Email author
  • J. Strauß
    • 2
  • A. Kolberg-Schwerdt
    • 1
  • M. Lempe
    • 1
  • F. Schlesinger
    • 1
  • U. Jaeschke
    • 1
  1. 1.Helios-Centre of Pediatric SurgeryBerlinGermany
  2. 2.Helios-Centre of AnaesthesiaBerlin-BuchGermany

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