Laparoscopic Repair of Larrey Hernia: A Case Report and Literature Review

Abstract

Morgagni-Larrey hernia is a rare pathology resulting from an anterior diaphragmatic defect. Diagnosis is often made in adulthood due to the lack of symptoms associated with this condition. Various surgical techniques have been reported for its treatment, but no standard approach has been established due to its rarity. Here, we present the case of a 42-year-old patient with a symptomatic Larrey hernia successfully treated with a laparoscopic approach. The rationale for documenting this case lies in contributing to the understanding and management of this rare condition.

Keywords: diaphragmatic hernia; general surgery; hernia surgery; laparoscopic surgery; morgagni-larrey hernia.

Figure 1. Frontal view of abdominal and thoracic CT scan showing an anterior diaphragmatic hernia containing transverse colon and greater omentum (yellow arrow)

Figure 2. Axial view of abdominal and thoracic CT scan displaying transverse colon and greater omentum in the anterior mediastinum (yellow arrow)

Figure 3. Sagittal view of abdominal and thoracic CT scan

The white arrow points to the large left anterior diaphragmatic hernia with the passage of the transverse colon. H: Heart, D: Diaphragm, L: Liver

Figure 4. Three trocars were used as shown

First, the 11-mm trocar was placed above the umbilicus for the scope, followed by the 5-mm trocar in the right flank and the 12-mm trocar in the left flank as working ports.

Figure 5. The progressive reduction of the transverse colon from the Larrey’s hernia

Figure 6. The defect after the reduction measuring 6 cm in length, 3 cm in width, and 10 cm in height

Figure 7. Intraoperative picture of the defect being closed by the V-lock

Figure 8. The Ventralight ST mesh in place

Figure 9. Immediate postoperative chest X-ray was normal

Figure 10. Abdominal and thoracic CT scan at six months shows no sign of diaphragmatic hernia recurrence (yellow and white arrow)

D: Diaphragm, H: Heart, L: Liver