Thoracoscopic repair in the neonatal intensive care unit for congenital diaphragmatic hernia during high-frequency oscillatory ventilation

J Laparoendosc Adv Surg Tech A. 2010 Feb;20(1):111-4. doi: 10.1089/lap.2008.0412.

Abstract

Aim: The aim of this work was to report the technique and result of thoracoscopic repair for a newborn with congenital diaphragmatic hernia (CDH) under high-frequency oscillatory ventilation (HFOV) in the neonatal intensive care unit (NICU).

Methods: Ventilation was supported by HFOV. The patient was placed in the right lateral decubitus position. Thoracoscopic surgery was performed through three 5-mm trocars. Carbon dioxide insufflation was maintained in the thoracic cavity at a pressure of 6-8 mm Hg. The hernia defect was repaired by using interrupted sutures with extracorporeal knots.

Results: The operation lasted 60 minutes. The intraoperative course was uneventful. Normal vital signs and PO(2) value were maintained throughout the operation. The patient had a normal chest X-ray 1 month after discharge.

Conclusion: Thoracoscopic repair of CDH in the NICU during HFOV is feasible and safe.

Publication types

  • Case Reports

MeSH terms

  • Female
  • Hernia, Diaphragmatic / surgery*
  • Hernias, Diaphragmatic, Congenital*
  • High-Frequency Ventilation*
  • Humans
  • Infant, Newborn
  • Intensive Care Units, Neonatal
  • Thoracoscopy*