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Research Article: Use of an endo fascial closure device for thoracoscopic patch repair of congenital diaphragmatic hernia

Date Published: 2026-09-14

Abstract:
This study describes a novel, simple, and reproducible technique for thoracoscopic patch repair of the diaphragm using an endo fascial closure device for the treatment of congenital diaphragmatic hernia (CDH). We retrospectively analyzed the clinical data of 18 patients with CDH who underwent thoracoscopic patch repair using the endo fascial closure device at our department between July 2021 and August 2026 In this study, follow-up of the 18 children ranged from 11 months to 4 years. The mean operative duration was 141.2?±?55.4?min. The mean duration of ventilator support was 8.39 days, and the mean postoperative hospital stay was 17.4 days. No conversion occurred intraoperatively. Postoperative chest radiography and upper gastrointestinal contrast study confirmed normal positioning of the abdominal organs in all patients. One death occurred due to treatment abandonment, and the remaining 17 children recovered favorably. The use of an endo fascial closure device for diaphragmatic suture under thoracoscopy represents a simple, novel, and easily reproducible technique. This method may potentially improve suturing efficiency and facilitate the management of large diaphragmatic defects, although its advantages over conventional techniques require validation in comparative studies.

Introduction:
Congenital diaphragmatic hernia (CDH), resulting from congenital dysplasia of the posterolateral diaphragm, exerts varying impacts on cardiopulmonary function and overall patient condition, with severe cases posing life-threatening risks ( 1 – 3 ). In the era of minimally invasive surgery, thoracoscopic techniques have been increasingly adopted for the repair of congenital diaphragmatic defects ( 4 , 5 ). However, current literature indicates that thoracoscopic repair is associated with notably higher recurrence…

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