Link: https://www.ncbi.nlm.nih.gov/pubmed/31229769

Int J Surg Case Rep. 2019 Jun 17;60:164-167. doi: 10.1016/j.ijscr.2019.06.022. [Epub ahead of print]
Hand-assisted laparoscopic surgery for Bochdalek hernia in an adult patient with a history of laparotomy: A case report.
Fukutomi S1, Arai S2, Fujisaki M2, Naritomi K2, Kawabata M2, Mano M2.
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Abstract
INTRODUCTION:
Bochdalek hernia (BH) is a congenital diaphragmatic hernia that generally occurs in infants and is rarely seen in adults. Surgical repair of BH is recommended, but the approach for repairing BH should be selected carefully in individual cases. It is well known that hand-assisted laparoscopic surgery (HALS) has the advantage of preserving tactile sensation compared with standard laparoscopic surgery. We describe an adult patient with a history of abdominal incisional hernia who developed BH that was treated safely by HALS.

PRESENTATION OF CASE:
An 87-year-old woman was admitted to our hospital with nausea. She had a history of right hemicolectomy and repair of an abdominal incisional hernia using mesh at 5 years after hemicolectomy. Chest and abdominal computed tomography revealed herniation of the gastric corpus through the left posterior diaphragm. BH was diagnosed and hernia repair by HALS was selected as the approach because dense adhesions were expected in the abdominal cavity. The operation was performed safely and her postoperative course was uneventful.

CONCLUSION:
HALS was useful, especially when removing adhesions around the hernial orifice. HALS is a feasible approach for BH and should be considered as one of the options in patients with a history of previous abdominal surgery.

Copyright 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.

KEYWORDS:
Abdominal incisional hernia; Bochdalek hernia; Case report; Hand-assisted laparoscopic surgery

PMID: 31229769 DOI: 10.1016/j.ijscr.2019.06.022
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