Asian J Endosc Surg

. 2022 Jul;15(3):674-677.

 doi: 10.1111/ases.13053. Epub 2022 Mar 15. https://pubmed.ncbi.nlm.nih.gov/35293150/

Combined laparoscopic and thoracoscopic approaches for Bochdalek hernia with hernia sac in an 8-years-old boy: Case report

Keiichiro Tanaka ¹, Takafumi Mikami ¹, Haruki Kato ¹, Tadaharu Okazaki ¹

Affiliations expand

• PMID: 35293150
• DOI: 10.1111/ases.13053

Abstract

Bochdalek hernia (BH) is characterized by a defect of the posterolateral diaphragm and intrathoracic herniation of abdominal organs. The laparoscopic or thoracoscopic approach has recently become the surgical standard. However, studies on combined approaches are limited. An 8-year-old boy diagnosed with left BH was treated using a combined laparoscopic and thoracoscopic approach. On laparoscopy, BH with hernia sac was identified. Spleen, pancreas tail, kidney, and transverse colon had herniated into the left thoracic cavity. After the adhesion between transverse colon and hernia sac was dissected, all abdominal organs were restored to the abdominal cavity. On thoracoscopy, an 8 × 8 cm hernia orifice defect was identified and closed by suture. The postoperative course was uneventful, with no recurrence. A combined laparoscopic and thoracoscopic approach is safe and effective with a good field of view for left BH with hernia sac in children. To the best of our knowledge, this is the first case with left BH reporting the use of both approaches in a child without conversion.

Keywords: bochdalek hernia; laparoscopic; thoracoscopic.

© 2022 Asia Endosurgery Task Force and Japan Society of Endoscopic Surgery and John Wiley & Sons Australia, Ltd.