Morgagni hernia: technical variation in the laparoscopic treatment

INTRODUCTION: Morgagni hernia is a rare entity that accounts for 3-5% of diaphragmatic hernias. They are mostly asymptomatic and discovered incidentally. Surgical treatment is indicated once diagnosis is made. Abdominal or thoracic accesses are possible using open or minimally invasive technique. METHODS: We report two cases of laparoscopic assisted repair of Morgagni hernia conduced by primary closure of the diaphragmatic defect with extracorporeal nonabsorbable sutures anchoring the diaphragmatic edge at the muscular fascia of the abdominal wall. RESULTS: Both patients had an uneventful postoperative recovery. The operative time was 90 and 60 minutes and the postoperative hospitalization was 4 and 2 days respectively. CONCLUSIONS: Laparoscopic intervention for Morgagni hernia repair is easy, safe and less invasive compared to the open one, with reduced hospitalization time. Primary closure of the diaphragmatic defect with extracorporeal nonabsorbable sutures is an effective technique for Morgagni hernia; defects larger than 20-30 cm(2) should be repaired using a prosthetic patch.