Authors
Andreicev I.L.1, Papoyan G.M.1, Gorbanev S.V.2
1 Municipal clinical hospital No. 31, Moscow
2 N.I. Pirogov Russian National Research Medical University, Moscow
Abstract
This article presents a clinical case of Morgagni-Larrey diaphragmatic hernia in combination with a hiatal hernia, which ended in a favorable outcome, due to a preoperative comprehensive examination and a planned surgical intervention performed using a robotic surgical complex Da Vinci Si. Complaints, anamnesis data, clinical, laboratory and instrumental studies have been presented. Surgical tactics have been described. The data of the control examination in the long-term postoperative period also have been presented. Morgagni-Larrey hernia is a rare pathology and the most optimal methods of surgical intervention are still being discussed. However, hernia repair should be performed as soon as possible after verification of the diagnosis due to the risk of developing obstruction or strangulation of organs. It is necessary to further study this pathology to improve the results of treatment and improve surgical techniques.
Keywords: Morgagni-Larrey diaphragmatic hernia, hiatal hernia, robotic-assisted diaphragm plasty with allograft, robotic-assisted fundoplication.
References
1. Minneci PC, Deans KJ, Kim P, Mathisen DJ. Foramen of Morgagni Hernia: changes in diagnosis and treatment. The Annals of Thoracic Surgery. 2004; 77(6): 1956-1959. doi: 10.1016/j.athoracsur.2003.12.028.
2. Comer TP, Clagett OT. Surgical treatment of hernia of the foramen of Morgagni. Journal of Thoracic and Cardiovascular Surgery. 1966; 52(4): 461-468.
3. Horton JD, Hofmann LJ, Hets SP. Presentation and management of Morgagni’s hernias in adults: a review of 298 cases. Surgical Endoscopy. 2008; 22(6): 1413-1420. doi: 10.1007/ s00464-008-9754-x.
4. Dapri G, Himpens J, Hainaux B, et al. Surgical technique and complications during laparoscopic repair of diaphragmatic hernias. Hernia. 2007; 11(2): 179-183. doi: 10.1007/ s10029-006-0161-8.
5. Arraez-Aybar LA, Gonzalez-Gomez CC, Torres-Garcia AJ. Morgagni-Larrey parasternal diaphragmatic hernia in the adult. Rev Esp Enferm Dig. 2009; 101(5): 357-366.
6. Durak E, Gur S, Cokmez A, et al. Laparoscopic repair of Morgagni’s hernia. Hernia. 2007; 11(3): 265-270. doi: 10.1007/s10029-006-0178-z.
7. Iso Y, Sawada T, Rokkaku K, et al. A case of symptomatic Morgagni’s hernia and a review of Morgagni’s hernia in Japan (263 reported cases). Hernia. 2006; 10(6): 521-524. doi: 10.1007/s10029-006-0123-1.
8. Loong TPF. Clinical presentation and operative repair of hernia of Morgagni. Postgraduate Medical Journal. 2005; 81(951): 41-44. doi: 10.1136/pgmj.2004.022996.
9. Thomas DS, Hui T, Phillips EH. Laparoscopic diaphragmatic hernia repair. Surg Endosc. 2002; 16(9): 1345-1349. doi: 10.1007/ s00464-001-8162-2.
10. Rattay T, Ubhi S. Morgagni hernia — an uncommon cause of gastric outlet obstruction. BMJ Case Reports. 2011; 24(1): bcr0520114264-bcr0520114264. doi: 10.1136/bcr.05.2011. 4264.
11. Grintcov AG, Sovpel IV, Sovpel OV, et al. Modern aspects of the diagnosis and surgical treatment of hiatal hernia. Neoplasm. 2020; 12(2): 63-71. doi: 10.26435/neoplasm.v12i2.322.
12. Arikan S, Dogan MB, Kocakusak A, et al. Morgagni’s Hernia: Analysis of 21 Patients with Our Clinical Experience in Diagnosis and Treatment. Indian Journal of Surgery. 2018; 80(3): 239-244. doi: 10.1007/s12262-016-1580-0.
13. Bortul M, Calligaris L, Gheller P. Laparoscopic repair of a Morgagni–Larrey hernia. J Laparoendosc Adv Surg Techn A. 1998; 8(3): 309-313. doi: 10.1089/lap.1998.8.309.
14. Bragg WD, Bumpers H, Flynn W, et al. Morgagni hernias: an uncommon cause of chest masses in adults. Am Fam Physician. 1996; 54(6): 2021-2024.
15. Rakas FS, Dayma KG, Gabukamble DB. Obstructed Morgagni’s hernia (A case report). Ind J Surg. 1988; 50: 144-146.
16. Eroglu A, Kurkcuoglu J, Karaoglanoglu N, Yilmaz O. Combination of paraesophageal hernia and Morgagni hernia in an old patient. Dis Esophagus. 2003; 16(2): 151-153. doi: 10.1046/j.1442-2050.2003.00315.x.
17. Eren S, Ciris F. Diaphragmatic hernia: diagnostic approaches with a review of the literature. European Journal of Radiology. 2005; 54(3): 448-459. doi: 10.1016/j.ejrad.2004.09.008.
18. Kuster GGR, Кline LE, Garzo G. Diaphragmatic hernia through the foramen of Moгgagni: laparoscopic repair case report. Journal of Laparoendoscopic Surgery. 1992; 2(2): 93-100. doi: 10.1089/lps.1992.2.93.
19. Wei B, Pittman BC. Robotic Morgagni hernia repair: an emerging approach to a congenital defect. Journal of Robotic Surgery. 2019; 13(2): 309-313. doi: 10.1007/s11701-018-0892-4.
20. Bianco FM, Paveljo Y, Gangemi A. Robotic Assisted Morgagni Hernia Repair. Robotic Assisted Hernia Repair. 2019: 445-456. doi: 10.1007/978-3-030-23025-8_29.
21. Cubas RF, Cheverie JN, Horgan S. Robotic paraesophageal hernia repair. Robotic Assisted Hernia Repair. Cham: Springer International; 2019: 457-474. doi: 10.1007/978-3-030-23025-8_30.
22. Sarkaria IS, Latif MJ, Bianco VJ, et al. Early operative outcomes and learning curve of robotic assisted giant paraesophageal hernia repair. The International Journal of Medical Robotics and Computer Assisted Surgery. 2017; 13(1): e1730. doi: 10.1002/rcs.1730.