A 48 year old otherwise fit man presented with increasing shortness of breath on exertion. An erect chest Xray showed what seemed to be a 'raised hemi-diaphragm'. A CT scan demonstrated that the shadowing was due the presence of viscera in the chest, due to a diaphragmatic hernia either congenital or traumatic. The anterior midline location was cocsistent with a Morgagni hernia.

No muscular diaphragmatic remnant exists anteriorly into which one can reliably place a suture or fix a patch. Interrupted 2/0 Prolene sutures on a straightened needle were passed through the anterior abdominal wall, through  the edge of the diaphragm and back over the costal margin, burying the knots in small cutaneous incisions.

Laparoscopic repair of a Morgagni hernia

Text & photo versionhttp://www.mactheknife.org/Photopages/Morgagni_repair/Morgagni_repair.html