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Research: Tension-free thoracoscopic repair of congenital diaphragmatic hernia combined with a percutaneous extracorporeal closure technique: how to do it

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Research: Tension-free thoracoscopic repair of congenital diaphragmatic hernia combined with a percutaneous extracorporeal closure technique: how to do it

Surg Today

. 2022 Nov 4.

 doi: 10.1007/s00595-022-02609-1. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/36333435/

Tension-free thoracoscopic repair of congenital diaphragmatic hernia combined with a percutaneous extracorporeal closure technique: how to do it

Koichi Deguchi 1Miho Watanabe 1Tomohisa Yoneyama 1Kazunori Masahata 1Motonari Nomura 1Ryuta Saka 1Hiroaki Yamanaka 1Masafumi Kamiyama 1Takehisa Ueno 1Yuko Tazuke 1Hiroomi Okuyama 2

Affiliations expand

Abstract

Purpose: Thoracoscopic repair (TR) of congenital diaphragmatic hernia (CDH) is associated with a higher recurrence rate than the conventional open method. We evaluated the effectiveness of our strategy for quality improvement, named “tension-free TR of CDH”.

Methods: The subjects of this retrospective analysis were 11 consecutive patients with CDH who underwent TR at our hospital between 2017 and 2021. Tension-free TR of CDH included the proactive use of an oversized patch for dome-shaped reconstruction and gapless suturing. We developed a percutaneous extracorporeal closure technique for secure suturing using a commercially available needle.

Results: Patch repair was performed in 8 (73%) patients and none required conversion to open surgery because of technical difficulties. Recurrence developed in one patient (9%), who underwent successful reoperation via TR. All patients had an uneventful postoperative course.

Conclusion: Tension-free TR combined with extracorporeal closure could reduce the difficulty of suturing and the risk of recurrence of CDH.

Keywords: Congenital diaphragmatic hernia; Recurrence; Thoracoscopic surgery.

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