Download PDF
Eur J Pediatr Surg 2022; 32(01): 127-131
DOI: 10.1055/s-0042-1742663
Original Article

Comparison of Optical Forceps-Assisted Single-Port Laparoscopic PIRS and Open Surgery in Morgagni Hernia Repair

Can İhsan Öztorun 
1   Department of Pediatric Surgery, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
,
Doğuş Güney 
1   Department of Pediatric Surgery, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
,
Hayal Doruk
2   Department of Pediatric Surgery, Ankara City Hospital, Children's Hospital, Ankara, Turkey
,
Tuğba Örnek Demir
2   Department of Pediatric Surgery, Ankara City Hospital, Children's Hospital, Ankara, Turkey
,
Sabri Demir
2   Department of Pediatric Surgery, Ankara City Hospital, Children's Hospital, Ankara, Turkey
,
Ahmet Ertürk
2   Department of Pediatric Surgery, Ankara City Hospital, Children's Hospital, Ankara, Turkey
,
Elif Emel Erten
2   Department of Pediatric Surgery, Ankara City Hospital, Children's Hospital, Ankara, Turkey
,
Müjdem Nur Azılı
3   Department of Pediatric Surgery, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
,
Emrah Şenel
4   Department of Pediatric Surgery, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
› Author Affiliations Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
› Further Information
    Permissions and Reprints

Abstract

Introduction This study aimed to compare the results of classical surgery (CS) and optical forceps-assisted single-port laparoscopic percutaneous internal ring suturing (SP-PIRS) repair for the treatment of Morgagni hernia.

Materials and Methods Patients with Morgagni hernia who were operated on between January 2005 and July 2020 were included in the study. Patients were divided into two groups (CS or SP-PIRS) and compared retrospectively in terms of demographic data, defect size, duration of hospitalization, costs, postoperative complications, and recurrence.

Results Thirty-two patients were included in this study. There were no statistically significant differences between the groups in terms of gender, defect size, postoperative complications, and recurrence (p > 0.05). The SP-PIRS group had a shorter operation time (p < 0.01), shorter hospital stay (p = 0.02), and lower cost (p < 0.01) than the CS group. The average follow-up was 24 months, and recurrence was detected in two patients in each group.

Conclusion SP-PIRS repair is recommended because it is practical to perform and reduces the duration of surgery, hospital stay, and cost. It is superior to other laparoscopic techniques, as there is no need to use additional study forceps, except in extreme cases, and the surgeon can perform the procedure without an assistant to hold the laparoscope.

Keywords

Morgagni hernia - single-port laparoscopic PIRS - open


Publication History

Received: 18 July 2021

Accepted: 17 January 2022

Article published online:
03 February 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Al-Salem AH, Zamakhshary M, Al Mohaidly M, Al-Qahtani A, Abdulla MR, Naga MI. Congenital Morgagni's hernia: a national multicenter study. J Pediatr Surg 2014; 49 (04) 503-507
    CrossrefPubMedGoogle Scholar
  • 2 Lauriti G, Zani-Ruttenstock E, Catania VD. et al. Open versus laparoscopic approach for Morgagni's hernia in infants and children: a systematic review and meta-analysis. J Laparoendosc Adv Surg Tech A 2018; 28 (07) 888-893
    CrossrefPubMedGoogle Scholar
  • 3 Alqahtani A, Al-Salem AH. Laparoscopic-assisted versus open repair of Morgagni hernia in infants and children. Surg Laparosc Endosc Percutan Tech 2011; 21 (01) 46-49
    CrossrefPubMedGoogle Scholar
  • 4 Al-Salem AH. Congenital hernia of Morgagni in infants and children. J Pediatr Surg 2007; 42 (09) 1539-1543
    CrossrefPubMedGoogle Scholar
  • 5 Simson JN, Eckstein HB. Congenital diaphragmatic hernia: a 20 year experience. Br J Surg 1985; 72 (09) 733-736
    CrossrefPubMedGoogle Scholar
  • 6 Mallick MS, Alqahtani A. Laparoscopic-assisted repair of Morgagni hernia in children. J Pediatr Surg 2009; 44 (08) 1621-1624
    CrossrefPubMedGoogle Scholar
  • 7 Ozmen V, Gün F, Polat C, Asoğlu O, Ozaçmak ID, Salman T. Laparoscopic repair of a Morgagni hernia in a child: a case report. Surg Laparosc Endosc Percutan Tech 2003; 13 (02) 115-117
    CrossrefPubMedGoogle Scholar
  • 8 Patkowski D, Czernik J, Chrzan R, Jaworski W, Apoznański W. Percutaneous internal ring suturing: a simple minimally invasive technique for inguinal hernia repair in children. J Laparoendosc Adv Surg Tech A 2006; 16 (05) 513-517
    CrossrefPubMedGoogle Scholar
  • 9 Yilmaz E, Afsarlar CE, Senel E. et al. A novel technique for laparoscopic inguinal hernia repair in children: single-port laparoscopic percutaneous extraperitoneal closure assisted by an optical forceps. Pediatr Surg Int 2015; 31 (07) 639-646
    CrossrefPubMedGoogle Scholar
  • 10 Yilmaz E, Afsarlar CE, Erdogan D, Ozguner IF. Outpatient single-port laparoscopic percutaneous Morgagni hernia repair assisted by an optical forceps. Minim Invasive Ther Allied Technol 2017; 26 (03) 182-187
    CrossrefPubMedGoogle Scholar
  • 11 Horton JD, Hofmann LJ, Hetz SP. Presentation and management of Morgagni hernias in adults: a review of 298 cases. Surg Endosc 2008; 22 (06) 1413-1420
    CrossrefPubMedGoogle Scholar
  • 12 Esposito C, Escolino M, Varlet F. et al. Technical standardization of laparoscopic repair of Morgagni diaphragmatic hernia in children: results of a multicentric survey on 43 patients. Surg Endosc 2017; 31 (08) 3320-3325
    CrossrefPubMedGoogle Scholar
  • 13 Alqadi G. Saxena AK. Laparoscopic Morgagni hernia repair in children: systematic review. J Pediat Endoscop Surg 2019; 1 (03) 85-90
    CrossrefPubMedGoogle Scholar
  • 14 Bawazir OA, Mahomed A, Fayyad A. et al. Laparoscopic-assisted repair of Morgagni hernia in children. Ann Pediatr Surg 2020; 16: 1-7
    CrossrefPubMedGoogle Scholar
  • 15 Tan YW, Banerjee D, Cross KM. et al; GOSH team. Morgagni hernia repair in children over two decades: institutional experience, systematic review, and meta-analysis of 296 patients. J Pediatr Surg 2018; 53 (10) 1883-1889
    CrossrefPubMedGoogle Scholar