Morgagni Hernia: How to approach!

Abstract Background Morgagni Hernia (MH) is a retrosternal herniation through inherent diaphragmatic defect manifested by respiratory and/or gastrointestinal symptoms and is repaired through transabdominal or transthoracic approaches. Methods The study aimed to evaluate thoracic and abdominal approaches in terms of operative and postoperative sequalae. Herein, we included 18 patients with MH operated in the Cardiothoracic Surgery Department at Mansoura University Hospital, Mansoura, Egypt over a period of 7 years. They were divided into two groups. Group I operated via right thoracotomy and Group II operated via paramedian laparotomy. Each group included 9 patients. Results Twelve males and 6 females with right sided MH were included. The mean operative times in thoracotomy and laparotomy groups were 99.44 ± 13.33 and 85.0 ± 20.92 min respectively but without statistical significance P  = 0.100. We recorded one recurrence in the thoracotomy group (group I) and one post-operative incisional hernia in the laparotomy group (group II). Conclusions MH should be repaired upon diagnosis. The optimal surgical technique should be tailored to the patient characteristics. Still, the abdominal approach was linked to easier feasibility, less operative time and recurrence rates.