Annals of Thoracic and Cardiovascular Surgery
Online ISSN : 2186-1005
Print ISSN : 1341-1098
Case Reports
Advantages of Video-assisted Thoracoscopic Surgery for Adult Congenital Hernia with Severe Adhesion: Report of Two Cases
Shinji NakashimaAtsushi WatanabeMakoto HashimotoTaijirou MishinaTakuro ObamaTetsuya Higami
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Volume 17 (2011) Issue 2 Pages 185-189

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Abstract

Adults who have undergone surgical repair of congenital diaphragmatic hernia have a prolonged illness. They usually have severe adhesions around the intrathoracic hernial sac; therefore, the adhesion itself as well as misidentification of the hernial defect can make surgical repair difficult, even in open surgery. Here, we present the successful video-assisted thoracoscopic surgical repairs of Bochdalek and Morgagni hernias in patients with severe adhesions of the hernial sac (peritoneum) to the parietal pleura lying over the thoracic wall and diaphragm. An 18-year-old woman with a Bochdalek hernia and a 28-year-old woman with a Morgagni hernia underwent thoracoscopic division of severe adhesions, proper minithoracotomy, and precise repairs of diaphragmatic defects. Postoperative courses of both patients were uneventful with no signs of recurrence of the hernia. Thus, we recommend the thoracoscopic approach as the first choice over an open or laparoscopic approach in the management of adult patients with Bochdalek or Morgagni hernias and severe adhesion.

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© 2011 The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery
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