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Laparoscopic assisted anterior transabdominal wall closure using loop suture removing technique in Morgagni hernia: safe and easy method

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Abstract

Purpose

The treatment of MH entails surgical repair either by open abdominal or thoracic approaches or by minimal invasive surgery. The aim of this study is to evaluate the surgical and clinical outcomes of children who underwent laparoscopic assisted transabdominal wall closure and subcutaneous knot placement technique.

Methods

This retrospective study includes pediatric patients who underwent surgery for MH between January 2015 and February 2019. The patients’ demographic data, symptoms, operative findings and technique and postoperative outcomes were recorded.

Results

A total of 17 children with MH were treated. There were 13 boys (76.5%) and four (23.5%) girls. Six patients had trisomy 21 (37%). The mean operation time was 40 min (25–90 min). The hernia sac was removed in all patients and there was no need for prosthetic patch in any of the children. Mean time to start feeding was 10 h (6–24 h). The mean hospitalization time was 2 days (1–5 days). There were no complications intraoperatively or postoperatively. The mean follow-up time was 24 months (6–40). No recurrence occurred during the follow-up time.

Conclusion

Laparoscopic assisted transabdominal wall closure and subcutaneous knot placement technique is a preferable method with excellent outcomes and short hospitalization and feeding time postoperatively. This technique may be performed easily and safely without requiring any additional experience other than basic laparoscopy skills.

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Availability of data and material

Patients’ data are available in the text.

References

  1. Golden J, Barry WE, Jang G et al (2017) Pediatric Morgagni diaphragmatic hernia: a descriptive study. Pediatr Surg Int. https://doi.org/10.1007/s00383-017-4078-3

    Article  PubMed  Google Scholar 

  2. Alqahtani A, Al-Salem AH (2011) Laparoscopic-assisted versus open repair of Morgagni hernia in infants and children. Surg Laparosc Endosc Percutaneous Tech. https://doi.org/10.1097/SLE.0b013e318209021f

    Article  Google Scholar 

  3. Lauriti G, Zani-Ruttenstock E, Catania VD et al (2018) Open versus laparoscopic approach for morgagni’s hernia in infants and children: a systematic review and meta-analysis. J Laparoendosc Adv Surg Tech 28:888–893

    Article  Google Scholar 

  4. Mallik K, Rodgers BM, McGahren ED (1995) Congenital diaphragmatic hernia: experience in a single institution from 1978 through 1994. Ann Thorac Surg. https://doi.org/10.1016/0003-4975(95)00617-T

    Article  PubMed  Google Scholar 

  5. Patkowski D, Czernik J, Chrzan R et al (2006) Percutaneous internal ring suturing: a simple minimally invasive technique for inguinal hernia repair in children. J Laparoendosc Adv Surg Tech. https://doi.org/10.1089/lap.2006.16.513

    Article  Google Scholar 

  6. Escarcega P, Riquelme MA, Lopez S et al (2018) Multi-institution case series of pediatric patients with laparoscopic repair of Morgagni hernia. J Laparoendosc Adv Surg Tech. https://doi.org/10.1089/lap.2017.0621

    Article  Google Scholar 

  7. Alkhatrawi T, Elsherbini R, Ouslimane D (2012) Laparoscopic repair of Morgagni diaphragmatic hernia in infants and children: do we need to resect the hernia sac? Ann Pediatr Surg. https://doi.org/10.1097/01.XPS.0000408615.05436.5f

    Article  Google Scholar 

  8. Slepov O, Kurinnyi S, Ponomarenko O, Migur M (2016) Congenital retrosternal hernias of Morgagni: manifestation and treatment in children. Afr J Paediatr Surg. https://doi.org/10.4103/0189-6725.182557

    Article  PubMed  PubMed Central  Google Scholar 

  9. Jetley NK, Al-Assiri AH, Al-Helal AS, Al-Bin Ali AM (2011) Down’s syndrome as a factor in the diagnosis, management, and outcome in patients of Morgagni hernia. J Pediatr Surg. https://doi.org/10.1016/j.jpedsurg.2010.10.001

    Article  PubMed  Google Scholar 

  10. Cigdem MK, Onen A, Okur H, Otcu S (2007) Associated malformations in Morgagni hernia. Pediatr Surg Int. https://doi.org/10.1007/s00383-007-2011-x

    Article  PubMed  Google Scholar 

  11. Ambrogi V, Forcella D, Gatti A et al (2007) Transthoracic repair of Morgagni’s hernia: a 20-year experience from open to video-assisted approach. Surg Endosc Other Interv Tech. https://doi.org/10.1007/s00464-006-9017-7

    Article  Google Scholar 

  12. Garriboli M, Bishay M, Kiely EM et al (2013) Recurrence rate of Morgagni diaphragmatic hernia following laparoscopic repair. Pediatr Surg Int 29:185–189

    Article  Google Scholar 

  13. Tan YW, Banerjee D, Cross KM et al (2018) Morgagni hernia repair in children over two decades: institutional experience, systematic review, and meta-analysis of 296 patients. J Pediatr Surg. https://doi.org/10.1016/j.jpedsurg.2018.04.009

    Article  PubMed  Google Scholar 

  14. Lamas-Pinheiro R, Pereira J, Carvalho F et al (2016) Minimally invasive repair of morgagni hernia—a multicenter case series. Rev Port Pneumol. https://doi.org/10.1016/j.rppnen.2016.03.008

    Article  PubMed  Google Scholar 

  15. Georgacopulo P, Franchella A, Mandrioli G et al (1997) Morgagni-Larrey hernia correction by laparoscopic surgery. Eur J Pediatr Surg 7:241–242

    Article  CAS  Google Scholar 

  16. Yilmaz E, Afsarlar CE, Erdogan D, Ozguner IF (2017) Outpatient single-port laparoscopic percutaneous Morgagni hernia repair assisted by an optical forceps. Minim Invasive Ther Allied Technol. https://doi.org/10.1080/13645706.2016.1263213

    Article  PubMed  Google Scholar 

  17. Uygun I, Okur MH, Aydogdu B et al (2013) Transumbilical scarless surgery with thoracic trocar: easy and low-cost. J Korean Surg Soc. https://doi.org/10.4174/jkss.2013.84.6.360

    Article  PubMed  PubMed Central  Google Scholar 

  18. Danielson PD, Chandler NM (2010) Single-port laparoscopic repair of a Morgagni diaphragmatic hernia in a pediatric patient: advancement in single-port technology allows effective intracorporeal suturing. J Pediatr Surg. https://doi.org/10.1016/j.jpedsurg.2009.12.029

    Article  PubMed  Google Scholar 

  19. Van Niekerk ML (2013) Laparoscopic morgagni hernia repair using single-site umbilical and full-thickness abdominal wall repair: technical report of two cases. Afr J Paediatr Surg 10:55

    Article  Google Scholar 

  20. Fernandez-Cebrian JM, De Oteyza JP (1996) Laparoscopic repair of hernia of foramen of Morgagni: a new case report. J Laparoendosc Surg. https://doi.org/10.1089/lps.1996.6.61

    Article  PubMed  Google Scholar 

  21. Rau HG, Schardey HM, Lange V (1994) Laparoscopic repair of a Morgagni hernia. Surg Endosc. https://doi.org/10.1007/BF00187355

    Article  PubMed  Google Scholar 

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Acknowledgements

Thanks to Bilgesu Arikan Ergun for the illustrations.

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All of the authors declare that they have all participated in the design, execution, and analysis of the paper, and that they have approved the final version.

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Correspondence to Ergun Ergun.

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Ethical Committee Approval was provided for the study (Approval no: 14-161-19).

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Ergun, E., Gollu, G., Ates, U. et al. Laparoscopic assisted anterior transabdominal wall closure using loop suture removing technique in Morgagni hernia: safe and easy method. Pediatr Surg Int 36, 679–685 (2020). https://doi.org/10.1007/s00383-020-04658-4

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