Thoracoscopic repair of congenital diaphragmatic hernia using barbed non-absorbable suture in infants and children; A retrospective study

The patients born with congenital diaphragmatic hernia (CDH) are increasingly surviving specially in the last decade which is mainly due to improvements in the early detection, fetal interventions, neonatal care, neonatal intensive care and surgical techniques and technologies. With the emergence and wide availability of minimal invasive surgery, thoracoscopic repair of CDH is now widely practiced and it is thought to minimize post-operative pain, decrease adhesion and scarring, and improve recovery. The purpose of this study is to report our experience of thoracoscopic CDH repair using a barbed non absorbable suture in a resource limited newly established minimal invasive surgery setup. This retrospective review was carried out in pediatric surgery unit Khyber teaching hospital, Peshawar. Data was collected from CDH patients operated electively from patient charts and outdoor patient slips and sample size of 23 was obtained since January 2021 till December 2023. The mean age of the patients was 1.5 years ±0.6years SD. The mean operative time was 40 minutes ±15 minutes SD. The mean length of hospital stay was 3 days ±2 days SD. Pyothorax, prolonged pneumothorax and prolonged ileus were noted in 1 patient each. Two patients (9%) presented with the recurrence in a six month follow up. Primary repair of CDH using barbed non-absorbable suture with thoracoscopy is viable option in appropriately selected infants and children.