Pleuroperitoneal hernias are congenital defects resulting in incomplete diaphragm formation. The diaphragmatic serosa surface remains intact, preventing communication between pleural and peritoneal cavities. Celiotomy for hernia repair is the treatment of choice.
To describe a rare case of successful laparoscopic repair of pleuroperitoneal hernia in a pediatric dog.
A two-month-old bitch was presenting dyspnea and vomiting. The patient was physically underdeveloped and presented pulmonary crackles and tachycardia. Radiographs showed cranioventral protrusion of the diaphragm. Congenital pleuroperitoneal hernia was suspected and the patient underwent laparoscopy for both confirming the diagnosis and surgical repair. A three-port approach was used. Trocars were placed in triangulation at the umbilical, right and left hypogastric area. Pleuroperitoneal hernia was confirmed during initial inspection. A polypropylene mesh was placed over the defect and attached to the abdominal wall and diaphragm using nylon 2-0 simple interrupted intracorporeal sutures. The incisions were sutured routinely.
Postoperative radiographs revealed intact diaphragm and normal pulmonary patterns. The patient was discharged 48 hours following surgery. On the 45th day of follow-up, the patient had no signs of complications and chest radiographs revealed no cardiac/pulmonary alterations, besides preserved diaphragm. Following six months, the patient underwent laparoscopic spay and the diaphragm was reexamined. The mesh was completely covered by adhesions among the liver lobes and the diaphragm. The lap-spay proceeded uneventfully and patient was discharged.
Laparoscopic repair of pleuroperitoneal hernia using polypropylene mesh was feasible and should be considered as a minimally invasive alternative to conventional surgery in dogs.