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Diaphragmatic hernia repair - series

Diaphragmatic hernia repair - congenital

Definition

Diaphragmatic hernia repair is surgery to correct a birth defect in which the diaphragm fails to completely develop. The diaphragm is the large dome-shaped muscle that separates the chest cavity from the belly area.

A diaphragmatic hernia requires immediate surgery.

See also: Diaphragmatic hernia

Description

While the child is under general anesthesia (asleep, no pain), the surgeon makes a cut in the upper abdomen under the ribs. The abdominal organs are gently pulled down through the opening in the diaphragm and placed into the abdominal cavity.

The surgeon repairs the hole in the diaphragm and stitches the cut closed. A plastic patch is used to cover large defects.

After surgery, a tube will remain in place for a few days to allow air, blood, and fluid to drain. This allows the affected lung to re-expand.

Why the Procedure is Performed

A diaphragmatic hernia can be a life-threatening situation and requires immediate surgery.

Recovery

Babies may to stay in the hospital for several weeks after surgery. The length of the hospital stay depends on the severity of the hernia and how long a breathing machine is needed.

Feeding will start after the first bowel movement is passed. Feeding is usually done through a tube into the stomach or small intestines until the breathing tube is removed.

Outlook (Prognosis)

Most babies need a breathing machine after surgery. The outcome depends on how well the baby's lung has developed. Generally the outlook is very good for infants with adequate lung tissue.

Risks

Risks for any anesthesia include:

• Breathing problems
• Reactions to medications

Risks for any surgery include:

• Bleeding
• Infection

Other possible complications specific to this surgery include:

• Collapsed lung
• Lung problems that continue

Review Date: 11/2/2007
Reviewed By: Deirdre O'Reilly, M.D., M.P.H., Neonatologist, Division of Newborn Medicine, Children's Hospital Boston and Instructor in Pediatrics, Harvard Medical School, Boston, Massachusetts.