Laparoscopic Management of Morgagni Hernias
Summary
Morgagni hernia represents a rare anterior defect of the diaphragm through which abdominal contents may protrude into the thoracic cavity. Historically managed through open abdominal or thoracic approaches, it has become increasingly amenable to minimally invasive repair. Laparoscopic management offers superior visualisation of the diaphragmatic defect, reduced postoperative pain, shorter hospital stay and faster return to normal activity. Surgical technique typically involves reduction of herniated contents, assessment or excision of the sac, primary closure of the diaphragmatic defect and reinforcement with a prosthetic mesh in cases of large or tension-prone orifices. Decisions regarding sac excision and mesh selection are guided by defect size, tissue quality and patient comorbidities. Reports indicate low recurrence rates and minimal morbidity when performed by experienced surgeons, although long-term follow-up data remain limited. The emergence of standardised port placement, advanced energy devices for sac dissection and development of composite meshes has further optimised outcomes. Globally, the laparoscopic approach has been adopted across adult and paediatric populations, underscoring its versatility and reproducibility in diverse clinical settings.
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Laparoscopic Management of Morgagni Hernias publication trend
The graph below shows the total number of articles in laparoscopic management of morgagni hernias across all publications each year (not limited to Nature Index journals).
Technical terms
Morgagni hernia: A congenital diaphragmatic defect located in the anterior retrosternal region allowing abdominal viscera to herniate into the thorax.
Laparoscopic repair: A minimal access surgical technique using small abdominal incisions and a camera to visualise and correct hernias.
Mesh reinforcement: The application of a synthetic or composite prosthesis to strengthen the repaired diaphragmatic defect and reduce recurrence risk.
Incarceration: Entrapment of herniated abdominal contents within the defect, limiting reduction and risking vascular compromise.
Strangulation: Compromised blood flow to herniated viscera, leading to ischaemia and potential necrosis if not promptly addressed.
References
- Morgagni−Larrey diaphragmatic hernia repair in adult patients: a retrospective single-center experience. Hernia (2020).
- Laparoscopic-assisted repair of Morgagni hernia in children. Annals of Pediatric Surgery (2020).
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