Robotic Transabdominal Preperitoneal Diaphragmatic Hernia Repair (Morgagni Hernia)

Background Morgagni hernia is a rare form of diaphragmatic hernia with a low incidence. Robotic surgery offers an interesting technique for sac reduction and extraperitoneal mesh placement. Method We present a case of a symptomatic Morgagni hernia, which was repaired utilizing the robotic transabdominal preperitoneal repair (rTAPP) approach. Results A 62-year-old female patient (157 cm, 80 kg, BMI 33 kg/m) presented with a symptomatic diaphragmatic hernia (Morgagni hernia). The defect size was 7 to 3 cm with a transverse colon inside the hernia sac and consecutive mediastinal shift. The hernia was repaired by using a robotic assisted minimal invasive approach. After preperitoneal dissection, using the monopolar scissor starting at the falciform ligament the hernia sac was reduced step by step. The defect was closed using barbed sutures. An uncoated 15 × 10 cm polypropylene mesh was placed in the preperitoneal space. Finally, the peritoneal incision was closed with a barbed suture. Posterior defects were closed conscientiously. Operation time was 138 min. Hospital stay was 4 days. There were no complications. Conclusion Robotic transabdominal preperitoneal repair (rTAPP) offers an excellent option for repairing of Morgagni hernia. The advantages of the use of a robotic system is the easy-to-manage dissection and the consecutive extraperitoneal/preperitoneal mesh placement without extensive fixation.