LAUSR

Dear Sir, Morgagni hernia is a rare diaphragmatic defect that results from a congenital failure of the pars sternalis to fuse with the costal arches [1]. Many authors advocate surgical repair for this type of hernia, even if it is asymptomatic [2]. The video vignette (Video S1) presents the laparoscopic repair of a Morgagni hernia. A 32-year-old male patient presented with a 2-month history of dyspnoea and abdominal discomfort. The patient had no previous history of operations or major trauma. CT scan revealed a large Morgagni hernia containing omental fat. A laparoscopic repair was performed. The patient was placed in the reverse Trendelenburg position under general anaesthesia and three trocars were used. The hernia content was easily reduced with gentle traction. The hernia sac was dissected free with mostly blunt dissection and resected. The suture of the free edge of the diaphragm to the anterior abdominal wall was performed using non-absorbable mattress sutures. A synthetic mesh was sutured and tacked in place to strengthen the repair. The postoperative course was uneventful and the patient was discharged on the fifth postoperative day. Follow-up CT scan showed no hernia recurrence and the patient remains symptom-free 5 years after the surgery. Laparoscopic repair of Morgagni hernias offers the diagnostic and therapeutic advantages of a minimally invasive approach.