Laparoscopic transperitoneal repair of pediatric diaphragm eventration using an endostapler device

Victoria Valinluck Lao, Oliver B. Lao, Shahab F Abdessalam

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Minimally invasive repairs of pediatric diaphragm eventration have been well described via a thoracoscopic approach, oftentimes requiring single-lung ventilation and tube thoracostomy, with the disadvantage of not being able to clearly visualize what lies beneath the diaphragm. We describe a novel pediatric diaphragm eventration repair using a laparoscopic transperitoneal approach and an endostapler device. We also describe our initial experience with this technique. Patients and Methods: Four pediatric diaphragmatic eventration patients underwent laparoscopic transperitoneal repair using an endostapler device. Repairs were performed in both male and female patients with right-sided eventrations. We approach the repair in a transperitoneal fashion using inverting sutures at the apex of the diaphragm to create tension toward the pelvis. Subsequently, an endostapler is used to remove the redundant portion of diaphragm, leaving a repaired, taut diaphragm. Results: The median age at operation was 10.5 months. The median operative time was 70 minutes. There was no mortality, surgical complications, or recurrence at a median follow-up of 17 months. Conclusions: This laparoscopic approach allows for clear visualization of the intraabdominal organs and, at least in our early experience, a very simple, straightforward operation. Additionally, with the use of the endostapler, the redundant, often weakened diaphragm is removed, leaving the native, healthy diaphragm behind, resulting in a reliable and reproducible repair. This repair should be considered as a feasible alternative approach to the more traditional open and thoracoscopic repairs.

Original languageEnglish (US)
Pages (from-to)808-813
Number of pages6
JournalJournal of Laparoendoscopic and Advanced Surgical Techniques
Volume23
Issue number9
DOIs
StatePublished - Sep 16 2013

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Diaphragmatic Eventration
Diaphragm
Pediatrics
Equipment and Supplies
One-Lung Ventilation
Thoracostomy
Patient Rights
Operative Time
Pelvis
Sutures
Recurrence
Mortality

ASJC Scopus subject areas

  • Surgery

Cite this

Laparoscopic transperitoneal repair of pediatric diaphragm eventration using an endostapler device. / Lao, Victoria Valinluck; Lao, Oliver B.; Abdessalam, Shahab F.

In: Journal of Laparoendoscopic and Advanced Surgical Techniques, Vol. 23, No. 9, 16.09.2013, p. 808-813.

Research output: Contribution to journalArticle

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