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Case Reports
. 2018 Jan;6(1):e27-e31.
doi: 10.1055/s-0037-1612618. Epub 2018 Mar 22.

Use of Nonabsorbable Spiral Tacks for Mesh Reinforcement in Thoracoscopic Repair of Congenital Diaphragmatic Hernia

Anna Poupalou  1   2 , Celine Vrancken  2 , Erwin Vanderveken  2 , Henri Steyaert  2
Affiliations
Case Reports

Use of Nonabsorbable Spiral Tacks for Mesh Reinforcement in Thoracoscopic Repair of Congenital Diaphragmatic Hernia

Anna Poupalou et al. European J Pediatr Surg Rep. 2018 Jan.

Abstract

Thoracoscopic prosthetic repair of congenital diaphragmatic hernia (CDH) is a well-established and safe technique in experienced hands but the patching procedure is technically demanding and time consuming. To address the challenges associated with this process (confined working space and restricted time), the aim of this article is to assess the potential improvements in feasibility, efficacy, and safety of patch fixation by using nonabsorbable helicoidal tacks in neonates and infants for the repair of large CDH by thoracoscopy. The new technique has all the advantages of minimal invasive surgery in very young children combined with the advantages of reduced operating time and increased simplicity, and may be a good option in cases of recurrence.

Keywords: diaphragmatic hernia; patch; tack; thoracoscopy.

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Conflict of interest statement

Conflict of Interest None.

Figures

Fig. 1
Fig. 1
Sites of port placement.
Fig. 2
Fig. 2
Diaphragmatic defect, partially repaired by thoracoscopic suturing.
Fig. 3
Fig. 3
Use of an appropriately sized mesh to close the diaphragmatic defect. The mesh is fixated to the diaphragm using spiral tacks.
Fig. 4
Fig. 4
Technique of anchorage of the mesh. It is crucial to secure circumferentially the mesh and deploy tacks perpendicular to the tissue, which can sometimes be challenging.
Fig. 5
Fig. 5
Postoperative chest radiograph: (A1) Immediate postoperative and (A2) Two days postoperatively. The size of the left lung gradually increased, and the mediastinal shift resolved.
See this image and copyright information in PMC

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