Robotic Transabdominal Preperitoneal Morgagni Hernia Repair

Authors

Chris Robert, HCA HealthcareFollow
Furrukh Jabbar, HCA HealthcareFollow

Files

Division

North Texas

Hospital

Medical City Plano

Specialty

General Surgery

Document Type

Poster

Publication Date

2025

Keywords

Morgagni hernia, congenital malformation

Disciplines

Congenital, Hereditary, and Neonatal Diseases and Abnormalities | Medicine and Health Sciences | Surgery

Abstract

Introduction: Morgagni hernia is a rare type of congenital diaphragmatic hernia, representing about 3% of all cases. It occurs due to a defect in the development of the diaphragm in the Morgagni foramen, also known as the sternocostal triangle. Case presentation: A 63-year-old woman with a past medical history of hypertension, hypothyroidism, Barrett’s esophagitis, and cirrhosis secondary to alcohol intake (Child Pugh A) presented with increasing shortness of breath and spasmodic right sided chest pain. A diagnostic workup with a CT chest revealed herniation of fat and a portion of the colon into the right chest with adjacent atelectasis of the lung. This case was done using a robotic transabdominal preperitoneal approach. The herniated contents were reduced, preserving the integrity of the pericardium and pleura. A preperitoneal flap was created, taking care not to disrupt the peritoneum, and the hernia was repaired primarily first using sutures; this was further reinforced with a Progrip mesh. A drain was then placed at the right upper quadrant. The patient had an uneventful recovery and was discharged on postoperative day 2 of surgery. The drain was removed at the 2-week postoperative follow up. Learning points: Morgagni hernia is a congenital hernia due to an anatomical defect in the sternocostal trigone. Although frequently detected in childhood, delayed presentation is more frequently present in females in the fifth decade, with the most common presenting symptoms being gastrointestinal and respiratory. There is still controversy on the optimal approach for surgery. A robotic preperitoneal approach is advantageous in that it allows for precise sac excision, wide dissection of the preperitoneal space, primary repair and mesh reinforcement. Conclusion: Robotic transabdominal preperitoneal approach for the repair of incarcerated diaphragmatic defects is a safe and valid option.

Original Publisher

HCA Healthcare Graduate Medical Education

Recommended Citation

Robert, Chris and Jabbar, Furrukh, "Robotic Transabdominal Preperitoneal Morgagni Hernia Repair" (2025). North Texas Research Forum 2025. 44.
https://scholarlycommons.hcahealthcare.com/northtexas2025/44