Our Summary

The research paper talks about a rare type of congenital hernia, known as Morgagni hernia (MH), which causes the organs in the abdomen to push up into the chest. This can potentially be life-threatening. Diagnosis of this condition is often delayed because it presents with common respiratory and gastrointestinal issues, making it hard to identify.

Once detected, the first line of treatment for both symptomatic and unnoticed cases of MH is surgery. This is because the herniated organs pose an increased risk of getting strangulated. Various surgical methods have been used over the years, but there’s no consensus on which is the best approach.

The article reviews literature on the management of MH over the past ten years. It also presents a case where a laparoscopic repair of an MH was performed, using a new technique that involves the use of a Falciform ligament flap.

FAQs

  1. What is a diaphragmatic hernia of Morgagni (MH)?
  2. What is the primary management for both symptomatic and incidentally discovered asymptomatic cases of MH?
  3. What is the novel reinforcement method for the laparoscopic repair of a MH using a Falciform ligament onlay flap?

Doctor’s Tip

A doctor may tell a patient undergoing hernia repair surgery to follow post-operative care instructions closely, including avoiding heavy lifting or strenuous activities for a period of time to allow for proper healing. It is important to attend all follow-up appointments and report any unusual symptoms or concerns to the doctor promptly. Additionally, maintaining a healthy lifestyle with regular exercise and a balanced diet can help prevent future hernias.

Suitable For

Patients who are typically recommended hernia repair are those with symptomatic diaphragmatic hernias, such as a diaphragmatic hernia of Morgagni, that pose a risk of strangulation. Surgery is also recommended for incidentally discovered asymptomatic cases of hernias, as the risk of complications can increase over time. Various surgical approaches can be used for hernia repair, with laparoscopic repair being a common and minimally invasive option. Ultimately, the decision for hernia repair should be made in consultation with a healthcare provider based on the individual patient’s specific circumstances.

Timeline

  • Before hernia repair:
  1. Patient may experience nonspecific respiratory and gastrointestinal complaints
  2. Correct diagnosis of MH may be delayed
  3. Herniated contents present increasing risk for strangulation
  4. Various thoracic and abdominal surgical approaches may be considered
  • After hernia repair:
  1. Surgical correction is the primary management for symptomatic and asymptomatic cases of MH
  2. In the past decade, various surgical approaches have been described for MH repair
  3. Novel techniques, such as the use of a Falciform ligament onlay flap, may be utilized for reinforcement during laparoscopic repair
  4. Patient may experience relief from symptoms and reduced risk of complications related to the hernia

What to Ask Your Doctor

  1. What are the symptoms of a hernia of Morgagni and how is it diagnosed?
  2. What are the potential risks and complications of hernia repair surgery?
  3. What type of surgical approach will be used for my hernia repair?
  4. How long is the recovery period after hernia repair surgery?
  5. Will I need to make any lifestyle changes or follow any specific post-operative care instructions?
  6. What are the success rates of hernia repair surgery for a hernia of Morgagni?
  7. Are there any alternative treatment options for my hernia?
  8. How often will I need follow-up appointments after hernia repair surgery?
  9. Are there any specific factors that may affect the outcome of my hernia repair surgery?
  10. Are there any specific dietary restrictions or precautions I should take before or after hernia repair surgery?

Reference

Authors: Sanford Z, Weltz AS, Brown J, Shockcor N, Wu N, Park AE. Journal: Surg Innov. 2018 Aug;25(4):389-399. doi: 10.1177/1553350618777053. Epub 2018 May 29. PMID: 29808766