Mousa Albeir, Sanusi Michael, Lowery Robert C, Genovesi Mark H, Burack Joshua H
Division of Cardiothoracic Surgery, State University of New York Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.
J Laparoendosc Adv Surg Tech A. 2006 Feb;16(1):54-8. doi: 10.1089/lap.2006.16.54.
Bochdalek hernias are congenital diaphragmatic hernias that are generally asymptomatic and often discovered incidentally. Surgical treatment is indicated once the diagnosis is made. These hernias have traditionally been repaired by open abdominal or thoracic approaches.
A healthy 24-year-old male presented with an 8-month history of shortness of breath. The patient was noted to have a postero-lateral diaphragmatic hernia, with a 4 cm defect in the left hemidiaphragm seen with computed tomography scan. He underwent hand-assisted video-assisted thoracoscopic surgery, in which the herniated omentum was reduced and the defect was repaired primarily and reinforced with Marlex mesh. The patient recovered uneventfully and was discharged home after a short hospitalization.
Video-assisted thoracoscopic surgery for repair of Bochdalek hernias offers diagnostic as well as therapeutic advantages as it provides an excellent view of the surgical field, is easily executed, results in minimal surgical trauma, and has excellent cosmetic results and rapid recovery. We report a hand-assisted intracorporeal thoracoscopic repair to be a secure and satisfactory adjuvant to achieve the repair and conclude that thoracoscopic repair of the rare Bochdalek hernia is feasible.
波氏疝是先天性膈疝，通常无症状，常为偶然发现。一旦确诊即需手术治疗。传统上这些疝通过开腹或开胸手术修复。
一名24岁健康男性，有8个月的气短病史。患者经计算机断层扫描显示后外侧膈疝，左半膈肌有4厘米缺损。他接受了手辅助电视胸腔镜手术，术中将疝出的大网膜回纳，缺损首先进行了修补，并用Marlex网片加强。患者恢复顺利，短期住院后出院回家。
电视胸腔镜手术修复波氏疝具有诊断和治疗优势，因为它能提供极佳的手术视野，操作简便，手术创伤极小，美容效果好且恢复快。我们报告手辅助体内胸腔镜修复是实现修复的一种安全且令人满意的辅助方法，并得出结论，胸腔镜修复罕见的波氏疝是可行的。
