Laparoscopic Diaphragmatic Hernia Repair

Diaphragmatic hernias represent a special category of abdominal hernias which are located at the natural diaphragmatic hiatus which naturally exists and permits the entrance of esophagus and great vessels from the thoracic to the abdominal cavity. When the hiatus enlarges it may allow the herniation of part of the stomach or other abdominal organs to the thoracic cavity.


Symptoms and diagnosis
Diaphragmatic hernias are often asymptomatic unless they are associated with gastro-esophageal reflux (GERD). GERD usually causes heartburn, food regurgitation, pain with swallow, hoarseness and recurrent picture of asthma or pneumonia. Diagnosis is usually made by barium swallow, gastroscopy or computed tomography.


Procedure and postoperative course
According to Professor Raftopoulos’ experience laparoscopic diaphragmatic hernia repair is performed through five small incision 2-4 cm or 1 to 1 and ¾ inches long. During the procedure the herniated organ is mobilized and retracted back to the abdominal cavity and the diaphragmatic hiatus is reduced in size with the placement of sutures. If GERD coexists then GERD is controlled with a fundoplication. Hospital stay is usually 1-2 days. Postoperative pain is usually controlled with Paracetamol or Acetaminophen. Return to work is usually possible within 7 days from surgery.


Laparoscopic diaphragmatic hernia repair is not usually associated with complications. Occasionally a pneumothorax may occur if the pleural space is accidentally violated during surgery. Postoperatively routine radiologic surveillance of the repair is recommended to detect hernia recurrence.


Dr. Raftopoulos’ experience
Dr. Raftopoulos has extensive experience in diaphragmatic hernia repair. This experience originates by the fact that diaphragmatic hernias are very frequent in obese patients and require concomitant repair during bariatric surgery. Although these repairs are technically challenging, they can be performed safely if such experience exists. In addition, Professor Raftopoulos has published his experience with laparoscopic diaphragmatic hernia repairs in peer reviewed medical journals such as the Surgical Endoscopy journal. For more information please contact our office.