Combined diaphragmatic hernia repair and sleeve gastrectomy in an obese patient: A case report

Introduction: Asymptomatic diaphragmatic hernia is generally rare among adults. Nonetheless, a subset of these patients can live a normal life and be exposed to many diseases, including obesity. When this rare event happens, surgical management can offer a solution to both problems simultaneously. Presentation of the case: We present the rare case of an obese patient with an asymptomatic chronic traumatic diaphragmatic hernia who desired bariatric surgery. After an extensive preoperative workout, we were able to repair the 5 x 4,5 x 3 cm diaphragmatic defect and complete a gastric sleeve at the same operative time without complications. Discussion: Simultaneous repair of diaphragmatic hernia and sleeve gastrectomy in obese patients has proven to be safe and effective. Although the literature is extremely scarce, with few case reports to our knowledge and after extensive literature research, this is the first case of a repair of traumatic diaphragmatic defect with concurrent sleeve gastrectomy. Conclusion: Concurrent bariatric and thoracoscopic traumatic diaphragmatic hernia repair is a rare combination but is feasible and safe as long as it's done in fully equipped specialized centers with expert surgeons.