Thoracoscopic Guided Pericostal Sutures as a Solid Fixation for Primary Closure of Congenital Diaphragmatic Hernias
<b>Purpose:</b> To describe a minimally invasive technique with primary closure and strong suture connection that is feasible in cases of larger, most common type B defects of congenital diaphragmatic hernia (CDH). <b>Background:</b> The thoracoscopic approach (TA) is a favor...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-07-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/9/8/1116 |
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| author | Armin-Johannes Michel Ulrike Metzger Steven Alan Rice Roman Metzger |
| author_facet | Armin-Johannes Michel Ulrike Metzger Steven Alan Rice Roman Metzger |
| author_sort | Armin-Johannes Michel |
| collection | DOAJ |
| description | <b>Purpose:</b> To describe a minimally invasive technique with primary closure and strong suture connection that is feasible in cases of larger, most common type B defects of congenital diaphragmatic hernia (CDH). <b>Background:</b> The thoracoscopic approach (TA) is a favorable technique for the repair of CDH and is still evolving globally. A common issue is finding the optimal suture technique for secure closure in order to prevent recurrences. Whether a defect can be closed only by sutures or by using a patch depends on the size of CDH, the presence of a muscular rim along the inner thoracic surface and finally on the surgeon’s experience. From a geometrical point of view, the challenge is to transform the circular defect into a line, without tension, with a strong compound and preferably without additional material. To address this, we apply a setting of the sutures in a “T-shape” and a way to lead the sutures around the rib bones in order to increase stability. This method allows for the primary closure of CDHs and also applies to larger defects. <b>Cases:</b> We present seven newborns with posterolateral CDH on the left side. The defects were solely repaired by TA and by the suturing technique described in detail. |
| first_indexed | 2024-03-09T04:36:01Z |
| format | Article |
| id | doaj.art-90ca78ff13e6499b988c7d522ba08afb |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-09T04:36:01Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-90ca78ff13e6499b988c7d522ba08afb2023-12-03T13:28:02ZengMDPI AGChildren2227-90672022-07-0198111610.3390/children9081116Thoracoscopic Guided Pericostal Sutures as a Solid Fixation for Primary Closure of Congenital Diaphragmatic HerniasArmin-Johannes Michel0Ulrike Metzger1Steven Alan Rice2Roman Metzger3Department of Pediatric and Adolescent Surgery, Paracelsus Medical University Hospital, 5020 Salzburg, AustriaDepartment of Pediatric and Adolescent Surgery, Paracelsus Medical University Hospital, 5020 Salzburg, AustriaUniversity Hospital for Children and Adolescents, Universitätsmedizin Rostock, 18057 Rostock, GermanyDepartment of Pediatric and Adolescent Surgery, Paracelsus Medical University Hospital, 5020 Salzburg, Austria<b>Purpose:</b> To describe a minimally invasive technique with primary closure and strong suture connection that is feasible in cases of larger, most common type B defects of congenital diaphragmatic hernia (CDH). <b>Background:</b> The thoracoscopic approach (TA) is a favorable technique for the repair of CDH and is still evolving globally. A common issue is finding the optimal suture technique for secure closure in order to prevent recurrences. Whether a defect can be closed only by sutures or by using a patch depends on the size of CDH, the presence of a muscular rim along the inner thoracic surface and finally on the surgeon’s experience. From a geometrical point of view, the challenge is to transform the circular defect into a line, without tension, with a strong compound and preferably without additional material. To address this, we apply a setting of the sutures in a “T-shape” and a way to lead the sutures around the rib bones in order to increase stability. This method allows for the primary closure of CDHs and also applies to larger defects. <b>Cases:</b> We present seven newborns with posterolateral CDH on the left side. The defects were solely repaired by TA and by the suturing technique described in detail.https://www.mdpi.com/2227-9067/9/8/1116repair of congenital diaphragmatic herniaCDHrecurrence of CDHthoracoscopic pericostal suture technique |
| spellingShingle | Armin-Johannes Michel Ulrike Metzger Steven Alan Rice Roman Metzger Thoracoscopic Guided Pericostal Sutures as a Solid Fixation for Primary Closure of Congenital Diaphragmatic Hernias Children repair of congenital diaphragmatic hernia CDH recurrence of CDH thoracoscopic pericostal suture technique |
| title | Thoracoscopic Guided Pericostal Sutures as a Solid Fixation for Primary Closure of Congenital Diaphragmatic Hernias |
| title_full | Thoracoscopic Guided Pericostal Sutures as a Solid Fixation for Primary Closure of Congenital Diaphragmatic Hernias |
| title_fullStr | Thoracoscopic Guided Pericostal Sutures as a Solid Fixation for Primary Closure of Congenital Diaphragmatic Hernias |
| title_full_unstemmed | Thoracoscopic Guided Pericostal Sutures as a Solid Fixation for Primary Closure of Congenital Diaphragmatic Hernias |
| title_short | Thoracoscopic Guided Pericostal Sutures as a Solid Fixation for Primary Closure of Congenital Diaphragmatic Hernias |
| title_sort | thoracoscopic guided pericostal sutures as a solid fixation for primary closure of congenital diaphragmatic hernias |
| topic | repair of congenital diaphragmatic hernia CDH recurrence of CDH thoracoscopic pericostal suture technique |
| url | https://www.mdpi.com/2227-9067/9/8/1116 |
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