Laparoscopic repair of a giant hernia of Morgagni

Morgagni's hernia presents with acute complication of the hernia itself like bowel obstruction or strangulation, or respiratory symptoms. Open or laparoscopic, trans-abdominal, trans-thoracic or combined surgical techniques have been used for defect reparing. We report a case of a 73-year-old woman, presenting with respiratory symptoms, affected by a Morgagni's Hernia containing the whole omentum and with the initial involving of transverse colon, which determined severe impairment of respiratory function. The patient underwent a laparoscopic approach, the sac was explored and partially retracted in abdomen but no dissection was tempted. A not preformed polypropylene mesh was placed upon the defect with at least 3 cm of overlapping. The post operative course was uneventful, the patient was discharged on IV post operative day. The debate on the safest and most effective modality to repair this rare hernia is still on the way. Since Morgagni' s hernia is a rarity, every single surgeon approaches it on the basis of his own preferences, so we believe no evidence based surgery will ever be applied to this rare defect. We report our experience, the surgical strategy and a review the literature on the outlined topics.