What type of doctor repairs a diaphragmatic hernia?

From the Guidelines

A thoracic surgeon or pediatric surgeon is the most suitable doctor to fix a diaphragmatic hernia, as they have the specialized expertise to perform the complex procedure required to repair the hole in the diaphragm and move abdominal organs back into their proper position. The choice of surgeon depends on the age of the patient and the type of hernia, with pediatric surgeons typically handling congenital diaphragmatic hernias in newborns and thoracic surgeons handling acquired diaphragmatic hernias in adults, often resulting from trauma 1.

Key Considerations

• The surgery may be performed through traditional open surgery or using minimally invasive techniques like laparoscopy or thoracoscopy, depending on the size and complexity of the hernia 1.
• Patients typically require close monitoring in an intensive care setting after surgery, especially infants with congenital hernias who may need ventilator support and specialized care for pulmonary hypertension 1.
• The use of mesh in diaphragmatic hernia repair is generally avoided in the emergency setting due to the risk of infectious complications, but biologic or biosynthetic meshes can be safely used in clean-contaminated and contaminated cases 1.

Surgeon Specialization

• Pediatric surgeons have completed a 5-year residency training in general surgery, plus a 2-year fellowship in pediatric surgery, and are certified by the American Board of Surgery 1.
• Thoracic surgeons have specialized training in the surgical treatment of conditions affecting the thorax, including diaphragmatic hernias 1.
• The American Board of Surgery offers a subspecialty certificate in pediatric surgery, which can be earned by those who have specialized in pediatric surgery 1.

Minimally Invasive Procedures

• Minimally invasive procedures, such as laparoscopy or thoracoscopy, can be performed by a pediatric surgeon or thoracic surgeon trained in these techniques 1.
• These procedures have been shown to have a low in-hospital mortality rate and similar outcomes in terms of perioperative morbidity and mortality compared to traditional open surgery 1.

From the Research

Types of Doctors Who Fix Diaphragmatic Hernia

• General surgeons: They are qualified to perform surgeries, including those related to diaphragmatic hernias 2, 3.
• Pediatric surgeons: Although they primarily focus on children, their expertise can be relevant in certain cases of diaphragmatic hernia, especially congenital ones 4.
• Laparoscopic surgeons: With the advancement of laparoscopic techniques, these surgeons can repair diaphragmatic hernias using minimally invasive methods 2, 5, 3.

Specialization and Training

• Subspecialty training, such as pediatric surgery, may affect outcomes in specific cases, but general surgeons are also capable of performing diaphragmatic hernia repairs 4.
• The choice of surgeon may depend on the type of hernia, the patient's age, and the complexity of the case.

Surgical Approaches

• Laparoscopic repair is a common approach for diaphragmatic hernias, offering benefits such as minimal invasiveness and shorter recovery times 2, 5, 3.
• Open surgery may be necessary in some cases, especially if the hernia is large or complex.
• The use of mesh reinforcement is a technique used in some repairs to prevent recurrence 2, 6, 3.