Giant left spontaneous diaphragmatic hernia repair via combined laparoscopic and thoracoscopic approaches

Abstract Spontaneous diaphragmatic hernias (DHs) are uncommon, yet potentially hazardous. To prevent consequences, timely diagnosis and treatment are necessary. A 54-year-old male presented to the emergency room with dyspnoea, cough and tachycardia; he had no history of trauma. Diagnostic imaging revealed a substantial left DH, indicating the need for surgical intervention. The intraoperative examination identified a transverse colon and omentum herniation. Dissection, reduction of the contents, primary sutures of the defect and dual mesh reinforcement accomplished the laparoscopic and thoracoscopic DH repair. This case underscores the importance of timely detection, precise surgical intervention and comprehensive post-operative monitoring when utilising a multidisciplinary approach to manage DHs. It serves as a reminder to exercise caution regarding DHs, particularly in circumstances devoid of traumatic aetiology and the benefits of combined laparoscopic and thoracoscopic approaches.