Reported here is the case of a 6 year old male child with a left Congenital
Diaphragmatic Hernia who underwent thoracoscopic repair. The use
of continuous low pressure CO2
insufflation pneumothorax during the
procedure not only made manipulation during the reduction of bowel
contents back into the abdomen easier, but also facilitated repair of
the defect as it maintained bowel reduction during suturing. Although
prolonged CO2
has been hypothesized to be hazardous leading to
hypercapnea and aggravating pulmonary hypertension in Congenital
Diaphragmatic Hernia patients. The authors found it to be a safe
modification of the technique as long as pre-operative planning, patient
selection and intra-operative maneuvers were proprely performed.
Hernias, Diaphragmatic, Congenital