MINIMALLY INVASIVE LAPAROSCOPIC REPAIR OF ACQUIRED DIAPHRAGMATIC HERNIA WITH COLONIC OCCLUSION IN A PATIENT WITH PRIOR THORACIC SURGERY: A CASE REPORT jorgeom96@gmail.com

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MINIMALLY INVASIVE LAPAROSCOPIC REPAIR OF ACQUIRED DIAPHRAGMATIC HERNIA WITH COLONIC OCCLUSION IN A PATIENT WITH PRIOR THORACIC SURGERY: A CASE REPORT

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Mexico

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Acquired diaphragmatic hernias most often result from trauma or, less frequently, iatrogenic causes. They can present acutely or be discovered incidentally, sometimes with complications such as bowel obstruction or visceral perforation. Traumatic hernias have an incidence of 1-5% after closed injuries and up to 10-15% in penetrating trauma. Iatrogenic hernias vary; for example, post-esophagectomy hernias can reach a 10.3% and is greater in minimally invasive techniques. Rarely, empyema necessitans a complication where empyema extends through the chest wall or diaphragm can cause herniation. Due to the risk of incarceration, strangulation, and respiratory compromise, surgical repair is recommended. The abdominal, thoracic, or combined approach is based on clinical presentation, stability, defect size, and surgical

This case involves a 55-year-old woman with a history of left lobectomy for lung abscess nine months prior, presenting with a diaphragmatic hernia and colonic occlusion. A laparoscopic approach was used, involving hernia dissection, herniated content reduction, and mesh placement (Simbotex) secured with tackers and sutures. Technical details and considerations are outlined to demonstrate reproducibility.

She was discharged the next day with good pain control, spontaneous diuresis, and no complications. Follow-up showed an uncomplicated recovery, and she resumed normal activities.

Laparoscopic repair offers significant benefits, including reduced complications, less pain, and faster recovery. This case highlights its safety and reproducibility in managing acquired diaphragmatic hernias.

https://vimeo.com/1115591839