title: Surgical technique and complications during laparoscopic repair of diaphragmatic hernias.
abstract: Diaphragmatic hernias can present as retrocostoxiphoid hernias (RCXH) or diaphragmatic dome hernias. The RCXH include the Larrey hernia (LH), the Morgagni hernia (MH), and the Larrey-Morgagni hernia (LMH). These congenital hernias are usually asymptomatic, and the diagnosis is simplified by two exams: chest X-ray, and thoraco-abdominal computed tomography (CT) scan. The potential risk in this condition is small-bowel incarceration in the hernia defect and subsequent obstruction. We report two cases of LH and one case of LMH treated by laparoscopy between February 2004 and October 2005, with a review of the surgical techniques. Two different laparoscopic techniques were used: the tension-free technique, and resection of the hernia sac with closure of the defect and reinforcement by prosthesis. One patient presented a postoperative cardiac tamponade due to a clip-induced bleeding of an epicardial artery at the inferior surface of the heart. Treatment by laparoscopy is feasible, but a consensus regarding the best laparoscopic repair is needed.
authors.affiliation: Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, Brussels, Belgium.
authors.forename: G
authors.initials: G
authors.lastname: Dapri
authors.forename: J
authors.initials: J
authors.lastname: Himpens
authors.forename: B
authors.initials: B
authors.lastname: Hainaux
authors.forename: A
authors.initials: A
authors.lastname: Roman
authors.forename: E
authors.initials: E
authors.lastname: Stevens
authors.forename: E
authors.initials: E
authors.lastname: Capelluto
authors.forename: O
authors.initials: O
authors.lastname: Germay
authors.forename: G B
authors.initials: GB
authors.lastname: Cadière
mesh_terms: D000293:Adolescent; D000368:Aged; D005260:Female; D006548:Hernia, Diaphragmatic / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods*; D008297:Male; D008875:Middle Aged