Large Sized Left Inferior Phrenic Artery and Parahiatal Type of Diaphragmatic Hernia Generating Confusion During Robotic Surgical Repair
| Autor: | Baongoc Nasri, Kirpal Singh, Kathryn Harris, Rocio Fuentes, Marius L. Calin, Aziz Sadiq, Gabriel Arevalo |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Diaphragm Diaphragmatic breathing 03 medical and health sciences 0302 clinical medicine Robotic Surgical Procedures Humans Medicine Diaphragmatic hernia Hernia Herniorrhaphy Ultrasonography Interventional Phrenic Artery Surgical repair Left inferior phrenic artery business.industry Ultrasonography Doppler Arteries Middle Aged Surgical Mesh Hernia repair medicine.disease Surgery Dissection 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology Hernias Diaphragmatic Congenital business |
| Zdroj: | Journal of Laparoendoscopic & Advanced Surgical Techniques. 27:283-287 |
| ISSN: | 1557-9034 1092-6429 |
| DOI: | 10.1089/lap.2016.0392 |
| Popis: | As an advanced minimally invasive surgical procedure, the repair of the diaphragmatic hernia may sometimes be very challenging especially when the anatomy is unclear.We are presenting a rare case of a parahiatal hernia defect repair where the understanding of the anatomy was complicated by the presence of an unusual large sized left inferior phrenic artery. The Da Vinci surgical platform was used to perform the entire procedure. Hernia sac dissection, identification of the crura, primary closure of the defect, and use of biologic mesh reinforcement were the main steps performed in the usual manner for hernia repair. In addition, the use of intraoperative ultrasound was of great utility to clarify the vascular anatomy.The additional time required for the intraoperative ultrasound and identification of the vascular anatomy has increased the duration of the procedure that otherwise was uneventful. The accurate identification of the anatomy allowed for a safe surgical outcome. The postoperative course was favorable and patient was free of symptoms at 1-month follow-up.The challenge of the repair of this rare, parahiatal type of diaphragmatic hernia where a large sized left inferior phrenic artery was also encountered was successfully mitigated by the use of the intraoperative Doppler ultrasound and by compliance with the basic steps of the procedure. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|