From the Research
The management of a Morgagni hernia typically requires surgical repair, especially for symptomatic patients or when complications are present, with the preferred approach being minimally invasive laparoscopic or robotic-assisted surgery. The decision to operate is based on the risk of future complications such as incarceration or strangulation, which can lead to significant morbidity and mortality. Surgical repair involves reducing the herniated contents back into the abdominal cavity and closing the diaphragmatic defect.
- The defect can be closed primarily with non-absorbable sutures when small,
- while larger defects often require mesh reinforcement using synthetic materials like polypropylene or biological meshes 1, 2. Asymptomatic Morgagni hernias discovered incidentally may be observed in select patients with high surgical risk, though most surgeons recommend repair due to the risk of future incarceration or strangulation.
- Postoperatively, patients typically require pain management with acetaminophen or NSAIDs,
- gradual return to normal activities over 2-4 weeks,
- and follow-up imaging to confirm successful repair 3, 4. Surgical repair is recommended because Morgagni hernias, which occur through a congenital anterolateral diaphragmatic defect, can lead to serious complications including bowel obstruction, strangulation, and respiratory compromise if left untreated. The most recent study 2 highlights the feasibility and safety of robotic-assisted repair for a Morgagni hernia, emphasizing its role in optimizing patient outcomes. However, the choice between laparoscopic and robotic-assisted approaches may depend on the surgeon's expertise and the specific patient's condition. In general, minimally invasive surgical techniques are preferred due to their advantages in reducing postoperative pain, wound complications, and hospital stay 1, 5.