Morgagni Hernia Repair in Children: Comparison of Laparoscopic and Open Results

Abstract

Morgagni hernias are anteromedial diaphragmatic defects that are typically simple to repair. As opposed to posterolateral defects, which are very difficult to expose laparoscopically, the anterior defects can be easily seen with this approach. We reviewed our experience with laparoscopic and open repair of Morgagni hernias in children and their associated outcomes. A retrospective review was conducted on all patients who underwent repair of Morgagni hernia from January 1994 to May 2009. Seventeen patients were identified, of whom 9 underwent laparoscopic repair and 8 underwent an open repair. The mean age at operation was 3 years (newborn to 14 years) with a mean weight of 20.7 kg (3.6-87.6 kg). Intraoperatively, the diaphragmatic defect size in maximal dimension ranged from 3 to 11 cm. There was no difference in the average age, weight, and defect size among both groups. Of those who underwent laparoscopic hernia repair, 5 patients were closed with a Surgisis-Gold (SIS) patch, 1 was closed primarily with interrupted sutures, and 3 were closed with transabdominal sutures. In the open group, 7 were closed primarily and 1 required SIS patch for closure. Mean length of stay was 3.0 ± 1.5 days in the open group compared with 1.1 ± 0.4 days in the laparoscopic group (P < 0.01). There were no intraoperative complications and no recurrences. Laparoscopic repair of Morgagni hernias is a relatively simple and effective method of repair in children with accentuated advantages of minimally invasive surgery.