Pacientes y Métodos. Nos ocupa el caso de un varón de 65 años, que consulta por cuadro de íleo mecánico incompleto, con radiología simple y contrastada, compatible con hernia diafragmática.
Técnica. Se utiliza la posición francesa con 3 puertas de entrada, usando escopio de 0°. Se reducen el epiplón y el colon transverso, sin extirpar el saco. Se realiza sutura discontinua de bordes, anudada subcutáneamente delante de la fascia de los músculos rectos.
Discusión. Habitualmente son hallazgos casuales. Ante los riesgos de complicación, es preciso confirmar el diagnóstico y practicar tratamiento quirúrgico.
Este procedimiento, por técnica laparoscópica, aporta mejoras en abordaje, técnica (mayor seguridad) y reintegración sociolaboral que la técnica por vía laparotómica
Patients and methods. A 65-year-old man presented with incomplete mechanical ileus. The images in plain and contrast radiography were compatible with diaphragmatic hernia.
Technique. The French position was employed with three trocar ports; a 0° endoscope was used. Reduction of omentum and transverse colon was carried out. The edges were sewn with a discontinuous suture, which was knotted subcutaneously in front of the fascia of the rectus muscles.
Discussion. These hernias are usually discovered incidentally. Given the risk of complications, the diagnosis must be confirmed and surgical treatment performed.
The laparoscopic procedure is an improvement over laparotomy in terms of the approach, the technique (safer) and the early return to normal social and profession activity on the part of the patient