Use of a prosthetic patch for laparoscopic repair of Morgagni diaphragmatic hernia in children

Background: Morgagni hernias are well suited to laparoscopic repair. A primary suture closure may result in tension on the repair, thereby predisposing the patient to a recurrence. A prosthetic patch ( PP) can be used to provide a tension- free repair. In this study, we reviewed our experience with the laparoscopic PP repair of Morgagni hernias in children. Methods: A retrospective chart review of all patients undergoing a laparoscopic Morgagni hernia repair using a PP was undertaken between November 2002 and January 2006. Outcome measures included age, gender, defect size, use of mesh, and outcome. The time of follow- up was from 6 to 37 months. Results: Seven ( 7) patients ( 6 male, 1 female) underwent a laparoscopic repair of Morgagni hernia during this time period. Six ( 6) patients had a congenital hernia, and 1 patient was thought to have an iatrogenic hernia following a sternotomy for heart surgery. Defect size ranged from 4 to 7 cm in maximum dimension. All operations were completed laparoscopically, no patients presented with recurrence, and no PP complications were encountered. Conclusions: The laparoscopic repair of Morgagni hernia using a PP can be performed with relative ease and with a positive outcome, and may prevent future recurrence by effecting a tension-free repair.