Robotic Assisted Repair of Morgagni Hernia
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Author: Michelle DeLeon, MD
Published:
Specialties: Cardiothoracic Surgery, General Surgery, Robotic Surgery
Schools: Jersey Shore University Medical Center, Rutgers- Robert Wood Johnson Medical School
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Loading...Contributors: Thomas Bauer, MD and Glenn Parker, MD
Up to 25 % of diaphragmatic hernias may be incidentally diagnosed in adulthood. If symptomatic, patients often present with epigastric pain, chest pain or persistent cough. When found, they should be repaired to prevent incarceration and strangulation.
Procedure
Robotic assisted repair of morgagni hernia
Indications
symptomatic or asymptomatic morgagni hernia
Contraindications
Inability to tolerate pneumoperitoneum because of medical comorbidities, previous extensive surgery (relative)
Instrumentation
Setup
The patient is placed in the supine position and the robot is docked in the left lower quadrant. The camera is placed in the supraumbilical region, and two 8 mm trocars are placed in the right and left midclavicular area in line with the camera. A right upper quadrant assistant port is placed.
Preoperative Workup
CT scan of the chest, abdomen and pelvis.
Anatomy and Landmarks
Advantages/Disadvantages
Advantages of the robot for repair of morgagni hernias lies primarily in the wrist like action of the robotic arms. This enables the surgeon to easily suture the defect primarily. It also enables the repair to be done minimally invasively, allowing for less post operative pain and a shorter hospital stay. Disadvantages may include cost.
Complications/Risks
Complications are hernia recurrence and injury to incarcerated contents during reduction.
Disclosure of Conflicts
Complications are hernia recurrence and injury to incarcerated contents during reduction.
Acknowledgements
References
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