The technical aspects of laparoscopic repair of diaphragmatic defects in neonates and infants

W. D Andrew Ford, Pedro Jose López, Nadesh Sithasanan, Hock L. Tan

Research output: Contribution to journalArticle

Abstract

Purpose: To present our experience with minimally invasive surgery for central and left-sided diaphragmatic defects in the neonate and infants. Methods: For congenital diaphragmatic hernia (CDH), the laparoscopic technique is helped by a port position well out in the left flank, a hitch stitch to hold the posterior muscle shelf forward during the repair, and the patient positioned with the head up and the left side rotated well forwards. For hemi-diaphragmatic palsy, in addition, two rows of plication could be achieved only after the left lobe of the liver had been detached from the diaphragm. For Morgagni hernia, the defect was closed with muscle-to-muscle sutures, with the patient supine. Results: Four patients, ranging in age from a neonate to 18 months, underwent successful primary laparoscopic repair of one Morgagni hernia, one hemi-diaphragmatic palsy, and two diaphragmatic hernias. Presenting symptoms ranged from minor, to one neonate requiring ventilatory support. The maximum length of stay after surgery was 6 days. There were no complications. Conclusion: This series demonstrated the feasibility of laparoscopic repair of central and left-sided diaphragmatic defects in children. The laparoscopic techniques are discussed, as are the steps which improved access and made the procedure easier.

Original languageEnglish
Pages (from-to)123-129
Number of pages7
JournalPediatric Endosurgery and Innovative Techniques
Volume8
Issue number2
DOIs
Publication statusPublished - Jun 2004
Externally publishedYes

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Newborn Infant
Paralysis
Muscles
Diaphragmatic Hernia
Minimally Invasive Surgical Procedures
Diaphragm
Sutures
Length of Stay
Head
Liver
Congenital Diaphragmatic Hernias

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

The technical aspects of laparoscopic repair of diaphragmatic defects in neonates and infants. / Ford, W. D Andrew; López, Pedro Jose; Sithasanan, Nadesh; Tan, Hock L.

In: Pediatric Endosurgery and Innovative Techniques, Vol. 8, No. 2, 06.2004, p. 123-129.

Research output: Contribution to journalArticle

Ford, W. D Andrew ; López, Pedro Jose ; Sithasanan, Nadesh ; Tan, Hock L. / The technical aspects of laparoscopic repair of diaphragmatic defects in neonates and infants. In: Pediatric Endosurgery and Innovative Techniques. 2004 ; Vol. 8, No. 2. pp. 123-129.
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