Laparoscopic Tension Free, Mesh Repair in Adult Cases of Diaphragmatic Defects: A Series of Four Cases.

Dr Ashok Kumar; Dr Nalinikanta Ghosh; Dr Anu Behari; Dr Shomnath Reddy

Volume : IX, Issue : VI, June - 2020

Laparoscopic Tension Free, Mesh Repair in Adult Cases of Diaphragmatic Defects: A Series of Four Cases.

Dr Ashok Kumar, Dr Nalinikanta Ghosh, Dr Anu Behari, Dr Shomnath Reddy

Abstract :

Introduction: Congenital diaphragmatic hernia is a rare entity even rarer in adults. Trauma is the most common cause of diaphragmatic hernia in adults. Here we are presenting four cases of different varieties of diaphragmatic hernia in adults. All four cases underwent to laparoscopic mesh hernia repair and shown excellent outcomes. Methods: From March 2017 to September 2019, four cases (three females, one male adult cases) of diaphragmatic hernia were admitted to our department of surgical gastroenterology in tertiary care institute. Patient presented with respiratory and gastrointestinal symptoms. They were evaluated with Chest X–ray, CT scan chest and abdomen. Case reports: Case 1 was a 47 year old female. She was present with complain of epigastric pain and diagnoses to have paraesophgeal hernia. She underwent for laparoscopic mesh repair and Nissens Fundoplication. Case 2 and 3 were 60 years male and 44 years female respectively. Both diagnosed to have morgagni hernia. They underwent for laparoscopic reduction and mesh hernioplasty. Case 4 was a 45 year female. She came to us with complain of epigastric pain and diagnosed to have posteriolateral diaphragmatic hernia which was laparoscopic mesh hernioplasty with Nissen�s Fundoplication. The postoperative period of all four patients was uneventful, except one patient, devolved intrathoracic fluid collection that was successfully managed by radiological intervention. Conclusion: Although the diaphragmatic hernia is a rare entity. However, high index suspicion leads early diagnosis and management. The laparoscopic tension free hernia repair could be a best option for management of diaphragmatic hernia without losing the advantages of minimal invasive surgery and lesser recurrence rate