Simplified technique for minimally invasive repair of congenital diaphragmatic hernia using hollow-needle snare and transthoracic traction stitches.

摘要: Abstract Background Minimally invasive (MI) congenital diaphragmatic hernia (CDH) repair can be challenging. Placing rib-anchoring stitches without creating skin incisions and closing wider defects are some of the difficulties. In Bochdaleck repair, maintaining visceral reduction minimizing pneumothorax use additional obstacles. We describe hollow-needle snares (HNS) transthoracic traction (TTS) to overcome these challenges. Methods Hollow-needle is assembled by passing a prolene stitch through hollow needle retractable snare, which used extract placed anchoring it over ribs but same stitch's entrance site. hernia, early placement TTS using HNS facilitate reduction, patch lay down, tension-free closure possible residual V-shaped defects. Results Between July 2009 April 2011, we performed 10 consecutive MI CDH repairs for 9 patients, including 7 3 Morgagni hernias. The median age was 8 days (range, 3-172 days), mean operative time 148.5 ± 37.8 minutes repairs. For 18.3 months 10.5-37 months), 100 26.5 minutes. All cases were completed conversion. One patient had recurrence repaired similarly, whereas others uneventful recovery at follow-up 5.8 1.1-23.7 months). Conclusion snare simple available tools that CDH. This initial experience demonstrates technique's effectiveness its excellent cosmetic outcomes.