Laparoscopic approach for Diaphragmatic Hernia Repair in Adult - A 7-year Review of Single Center Experience

Author(s): Taewook Yoo, Duyeong Hwang, Yun kyung Kang, Yonghae Baik

Purpose: Diaphragmatic hernia in adults is a rare but potentially lifethreatening condition that often presents diagnostic and surgical challenges. With the increasing adoption of minimally invasive techniques, laparoscopic repair has emerged as a promising approach, yet evidence- particularly in elderly patients and in rare hernia subtypes- remains limited. This study aimed to evaluate the safety, feasibility, and outcomes of laparoscopic diaphragmatic hernia repair performed by a single experienced surgeon at a single center over a seven-year period.
Methods: A retrospective review was conducted of adult patients who underwent laparoscopic repair of diaphragmatic hernia at Dongguk University Ilsan Hospital between November 2017 and September 2023. Clinical data, including demographics, presenting symptoms, hernia characteristics, operative details, postoperative outcomes, and follow-up findings, were analyzed.
Results: Eleven patients (10 females; mean age, 73.8 ± 14.4 years) underwent laparoscopic repair. Hernia types included hiatal hernia (n=6, 54.5%), Morgagni hernia (n=4, 36.4%), and Bochdalek hernia (n=1, 9.1%). One patient (9.1%) required conversion to open surgery due to intraoperative pneumothorax. The mean operative time was 242.4 ± 109.6 minutes, and the mean hospital stay was 16.2 ± 11.3 days. Postoperative complications occurred in 2 patients (18.1%), all minor (Clavien–Dindo grade ≤ IIIa), and resolved with conservative management. There were no major complications, no 30-day mortalities, and no clinical or radiological recurrences during a mean follow-up of 16.3 ± 7 months.
Conclusion: Laparoscopic repair of adult diaphragmatic hernias is safe and feasible, even in elderly patients, and is associated with low morbidity and no mid-term recurrences.