Laparoscopic surgery of diaphragmatic diseases in children:: Our experience with five cases

Aims: In paediatric surgery the laparoscopic approach can be used to repair diaphragmatic anomalies originating from the abdomen or containing abdominal viscera. Candidates for laparoscopic correction are children with mild symptoms and good respiratory and haemodynamic conditions. The authors present their experience with 5 patients treated successfully for different types of diaphragmatic lesions. Patients and Methods: Five children were treated laparoscopically since 1998. Two true Morgagni-Larrey hernias, one recurrent left Bochdalek hernia, one diaphragmatic dysontogenetic cyst and one huge congenital sliding and rolling hiatal hernia. All the herniated viscera were repositioned in the abdomen and the defects - including the diaphragmatic hole at the level of the dysontogenetic cyst - were directly sutured without the use of a mesh. Results: All patients are healthy without signs of recurrence observed at chest X-ray after a follow-up of 3 months to 1 year. Discussion: Under specific conditions the laparoscopic approach can be an effective and more advantageous alternative to laparotomy for diaphragmatic congenital diseases in a paediatric population.