Traumatic Diaphragmatic Hernia: Safety and Efficacy of a Minimally Invasive Approach: Case Report

Abstract

Missed diagnosis of traumatic diaphragmatic hernia is a known complication of blunt trauma as the diagnosis can be difficult to ascertain acutely. Pre-operative diagnosis is challenging, and to date, there is no consensus on the standard management for this condition. Until recently, open primary repair was the standard of care with few centers attempting laparoscopic repair for select patients. The objective of this study was to evaluate the safety, technical feasibility, and clinical outcomes for minimally invasive repair utilizing the DaVinci Robotic platform for traumatic diaphragmatic hernia repair. Robotic repair was performed on a patient who presented with a large diaphragmatic hernia 9 years after blunt trauma. The procedure was recorded, technique detailed, and clinical outcomes assessed. There were no significant adverse events noted. After 1 year, the patient is doing well with no complaints, no evidence of recurrence and no other complications. Robotic repair of traumatic diaphragmatic hernia effectively achieved reduction of herniated contents, primary defect closure, and broad mesh overlap with good results at 1 year. This approach may provide an innovative minimally invasive option for surgeons and patients.