Laparoscopic Repair of Morgagni and Larrey’s Hernia, a Rare Presentation: A Case Report and Review Literature

Abstract

Introduction: The Morgagni hernia is one of the rarest hernias, with the overall incidence rate of 3% of all the diaphragmatic hernias. Laparoscopic repair has proved to be successful in the repair of this hernia. The minimal access surgery entails the benefits of the early ambulation and less necessity of analgesia with early postoperative recovery. The defect closure can be done with primary closure or using the prosthetic mesh which may be composite or polypropylene. The recurrence rate is not yet exactly known in cases of primary repair. Some studies favor the use of prosthetic mesh in all the cases of diaphragmatic mesh repair. Case Presentation: A 75 year old lady presented with complaints of abdominal pain for 4 to 5 months and vomiting for 1 month along with a history of intermittent fever. Physical examination revealed tenderness in the epigastrium. She was resuscitated and posted for the laparoscopic diaphragmatic hernia repair with prosthetic composite mesh placement. Conclusions: The Morgagni hernia repair with minimal access surgery may be a boon in the surgical field. This is a rare case of hernia in both the Morgagni’s and Larrey’s space, demonstrating all the benefits of minimal access surgery. Further randomized control trials may be needed to prove the exact advantages of minimal access surgery vs open surgery.