Franklin ME, Gálvez HC, Treviño JM, Villegas CO, Salgado CL, Salazar LD

Language: English
References: 24
Page: 257-261
PDF size: 110.02 Kb.

ABSTRACT

Background: The use of omentum to cover sternal dehiscence historically has required a formal laparotomy. The laparoscopic approach to harvest omentum has the potential to decrease the physiological stress of laparotomy and its complications. This technique was first reported by Saltz in 1993. On the other hand, in 1995, Marks published the first case of successful laparoscopic repair of a diaphragmatic hernia. Since then, other reports have appeared in the surgical literature that support the safety, feasibility, and advantages of laparoscopic repair compared with conventional surgery.
Description: A 75-year-old male patient with a history of coronary artery bypass grafting procedure. His sternotomy got infected and underwent surgical debridement producing a chest wall defect. Two months later, he underwent a laparoscopic omental flap harvest for coverage of the thoracic defect. Seven months later, he developed a diaphragmatic hernia containing most of the stomach inside the thorax. He was operated laparoscopically, reducing the hernia sac, closing the diaphragmatic defect, and reinforcing it with a Surgisis^® mesh. His postoperative course showed no complications and was discharged in good condition.
Discussion: To our knowledge, this is the first reported case of a laparoscopic repair of a diaphragmatic hernia occurring as a late complication of laparoscopic omental flap harvest for sternal reconstruction. Our results show that this procedure is safe and without short-term complications.

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