J Laparoendosc Adv Surg Tech A

. 2021 Sep 27. doi: 10.1089/lap.2021.0420. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/34569855/

Thoracoscopic Neonatal Congenital Diaphragmatic Hernia Repair: “How We Do It”

Drew A Rideout ¹, Mark Wulkan ²Affiliations expand

• PMID: 34569855
• DOI: 10.1089/lap.2021.0420

Abstract

Background: Congenital diaphragmatic hernia (CDH) is a relatively common congenital anomaly, typically requiring repair in the neonatal period. Approaches to surgical repair of a CDH are varied. A small defect may be repaired primarily while a large defect often requires a patch repair. Minimally invasive and open techniques have been reported to have varying benefits and outcomes. Materials and Methods: The authors describe their technique of CDH repair and present a review of the literature. Results: In a stabilized neonate with a small-to-moderate CDH defect, a thoracoscopic primary repair with biological mesh underlay (or a patch repair if needed to reduce tension) represents our approach of choice to treat this pathology. However, attention to specific technical details is required to minimize incidence of recurrence. Conclusions: The data favor a minimally invasive approach to CDH repair in the appropriate patients.

Keywords: congenital diaphragmatic hernia; neonatal; thoracoscopy.