Thoracoscopic Repair of Diaphragmatic Hernia in Infants: A New Modification of the Technique

Abstract

Purpose The objective of this study is to evaluate a novel simplified technique of thoracoscopic repair of congenital diaphragmatic hernia (CDH) in infants.

Methods A retrospective review of the new simplified technique in 12 CDH patients admitted between March 2013 and March 2015 was performed. A needle with nonabsorbable 2–0 sutures threaded in the lumen was used to approximate edges of the hernia defect.

Results A total of 12 infants with CDH underwent the repair successfully using this new technique. There were 7 boys and 5 girls with a median age of 104.7 days (range, 1 days–17 months). The mean operative time was 65 minutes (range, 35–125 minutes). No conversion or synthetic patch was required. The patients were followed up for 6 to 30 months (mean, 17.5 ± 8.5 months). There was no mortality and no recurrence.

Conclusion The new modified technique of thoracoscopic diaphragmatic hernia repair reduces the difficulty of intracorporal suturing under tension.

Keywords

congenital diaphragmatic hernia - syringe needle - thoracoscopy - children

^* Wang Ye-Bo and Li Bing contributed equally to the article and share first authorship.

• References

• 1 Guner YS, Chokshi N, Aranda A , et al. Thoracoscopic repair of neonatal diaphragmatic hernia. J Laparoendosc Adv Surg Tech A 2008; 18 (6) 875-880
• 2 van den Hout L, Sluiter I, Gischler S , et al. Can we improve outcome of congenital diaphragmatic hernia?. Pediatr Surg Int 2009; 25 (9) 733-743
• 3 Liem NT, Nhat LQ, Tuan TM, Dung A, Ung NQ, Dien TM. Thoracoscopic repair for congenital diaphragmatic hernia: experience with 139 cases. J Laparoendosc Adv Surg Tech A 2011; 21 (3) 267-270
• 4 Shalaby R, Gabr K, Al-Saied G , et al. Thoracoscopic repair of diaphragmatic hernia in neonates and children: a new simplified technique. Pediatr Surg Int 2008; 24 (5) 543-547
• 5 Kim AC, Bryner BS, Akay B, Geiger JD, Hirschl RB, Mychaliska GB. Thoracoscopic repair of congenital diaphragmatic hernia in neonates: lessons learned. J Laparoendosc Adv Surg Tech A 2009; 19 (4) 575-580
• 6 Okazaki T, Nishimura K, Takahashi T , et al. Indications for thoracoscopic repair of congenital diaphragmatic hernia in neonates. Pediatr Surg Int 2011; 27 (1) 35-38
• 7 Gomes Ferreira C, Reinberg O, Becmeur F , et al. Neonatal minimally invasive surgery for congenital diaphragmatic hernias: a multicenter study using thoracoscopy or laparoscopy. Surg Endosc 2009; 23 (7) 1650-1659