A case of laparoscopic repair for traumatic diaphragmatic hernia in a patient who had previously undergone surgery for esophageal cancer Fumihiko FUJITA 1 , Yusuke INOUE 1 , Ryo MATSUMOTO 1 , Kengo KANETAKA 1 , Mitsuhisa TAKATSUKI 1 , Susumu EGUCHI 1 1Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences Keyword: 腹腔鏡下手術 , 外傷性横隔膜ヘルニア , 食道癌手術 pp.45-49
Published Date 2018/1/15
DOI https://doi.org/10.11477/mf.4426200504
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A man in his 80's was transferred to our hospital due to injuries sustained in a bicycle accident. Although a left leg fracture was suspected, a CT scan revealed the presence of a diaphragmatic hernia. He was finally diagnosed with traumatic diaphragmatic hernia, and emergency surgery was thus performed. As the patient had previously undergone open surgery for esophageal cancer, surgical scars from the previous right posterolateral thoracotomy and laparotomy in the epigastric region were observed. Regarding the method of reconstruction, his stomach had been used as a gastric tube via the posterior mediastinal route. This surgery to treat the hernia was performed laparoscopically using three trocars. The site of rupture was found on the left side of the diaphragm near the stomach route, and the small intestine was found to protrude into the thoracic cavity. The small intestine was pulled back to the abdominal cavity and then the ruptured diaphragm was continuously sutured laparoscopically. The laparoscopic procedures were useful for treating traumatic diaphragmatic hernia despite the patient's history of esophageal cancer surgery.

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