To investigate the clinical effects of laparoscopic repair of delayed traumatic diaphragmatic hernia through abdominal approach.

The clinical data of 43 patients with delayed traumatic diaphragmatic hernia who underwent transabdominal laparoscopic repair from January 2014 to June 2021 in four hospitals in Hunan Province were retrospectively analyzed. The contents of the hernia into the chest cavity were reduced to the abdominal cavity, and the rupture hole of the diaphragm was closed with absorbable 2-0 suture or barb wire. The hernia ring opening was centered on and the anti-adhesion composite mesh of the corresponding size was selected according to the incisional hernia repair principle, and the central area and surrounding area were sutured with 3-0 prolene with 3 stitches. The remaining parts were sutured continuously with 3-0 absorbable suture or barb wire. The outer part of the mesh can also be fixed on the diaphragm with the hernia screw nail to achieve the purpose of repairing the defect. Follow-up was conducted by telephone and outpatient interview every 3 months after surgery, including postoperative clinical symptoms and recurrence of hernia.

All 43 patients with delayed traumatic diaphragmatic hernia successfully underwent laparoscopic tension-free diaphragmatic hernia repair. The mean operation time was 174.5 min, the mean intraoperative blood loss was 75 ml, and the mean postoperative hospital stay was 12 days. There were 32 patients with more bloody pleural effusion after operation, which recovered after treatment, and 12 patients with dull pain and discomfort on the affected side of chest and back, which disappeared after corresponding treatment. There were no respiratory and digestive complications, and the respiratory and digestive symptoms that existed before surgery were relieved and disappeared. All patients were followed up for 2 years. Until the end of the follow-up, all the 43 patients had no serious postoperative complications and no recurrence.

Laparoscopic repair of delayed traumatic diaphragmatic hernia through abdominal approach is a safe, reliable, and minimally invasive method with rapid recovery.