Video-Assisted Thoracoscopic Surgery Repair of Diaphragmatic Hernia With Prolene Mesh After Microwave Ablation

Microwave ablation (MWA) is one of the minimally invasive techniques utilized in the treatment of hepatocellular carcinoma (HCC). MWA has become an increasingly popular and comparable alternative therapy to radiofrequency ablation (RFA) with similar major complication and mortality rates. Diaphragmatic hernia is a rare complication of MWA. Current literature has very few reports on the management of such complications. This article describes a case of multifocal HCC treated with MWA, complicated by pleural effusion and diaphragmatic herniation of the omentum into the right intrathoracic cavity. The surgical repair of the diaphragmatic defect was performed via video-assisted thoracoscopic surgery (VATS) approach with Prolene mesh reinforcement. Further studies are needed for evaluation of the best surgical approach to manage post-MWA-related diaphragmatic hernias.