Laparoscopic repair of traumatic diaphragmatic hernias

Abstract

Background: Traumatic diaphragmatic hernias are serious complications of blunt abdominal or thoracic trauma. In the early posttraumatic period, they are often missed, and they may be followed by a variety of subacute or chronic symptoms due to pulmonary or intestinal obstruction.

Methods: We present three cases of traumatic diaphragmatic hernias. Two of them were successfully treated by laparoscopy and direct suturing during the early posttraumatic period; the other was treated 10 years after the trauma.

Results: We found that laparoscopy is a safe, successful, and gentle procedure not only for diagnosis but for treatment as well. The postoperative course was uneventful in all cases. All patients remained asymptomatic during long-term follow-up (42–60 months). These results are promising. We expect the same good long-term results after laparoscopic repair as after open conventional surgery.

Conclusion: We recommend that surgeons with sufficient experience in laparoscopy use a minimally invasive approach to treat chronic as well as acute traumatic diaphragmatic hernias in hemodynamically stable patients.