Abstract

Objectives: This study aimed to compare the outcomes of the laparoscopic transfascial suturing technique with open surgical repair in pediatric Morgagni hernia (MH) cases and to evaluate the association between recurrence and patient-related factors

Patients and methods: Between January 2018 and December 2024, 19 pediatric patients (11 males, 8 females; median age: 11 months; range: 5 to 67 months) who underwent surgical repair for MH were retrospectively reviewed and divided according to surgical technique into an open surgery group (OS, n = 9) and a laparoscopic group (LP, n = 10), and clinical outcomes were compared. Patient age, sex, presenting symptoms, imaging findings, associated anomalies, surgical technique, operative time, recurrence, and length of hospital stay were evaluated. Non-parametric tests were used due to the small sample size. Effect sizes were calculated to supplement p-values.

Results: The admission symptoms were recurrent respiratory tract infections in seven cases in each group (p = 1.00). Associated congenital anomalies were present in seven cases in the OS group and eight cases in the LP group (p = 1.00). No intraoperative complications were observed in either group. One patient in the LP group experienced minor postoperative morbidity. The mean total operation time was comparable in both groups (OS: 92.78 ± 33.83 min, LP: 96 ± 22.21 min; p = 0.591; Cohen’s d = 0.11). The mean hospital stay was significantly shorter in the LP group compared to the OS group (3.5 ± 0.71 days vs. 6.67 ± 3.42 days; p = 0.009; Cohen’s d = 1.28). Three patients with Down syndrome experienced recurrence in the LP group. Reoperation was performed in all three cases.

Conclusion: These preliminary findings suggest that laparoscopic transfascial repair provides a shorter hospital stay compared to open repair in pediatric MH, with comparable operative times. However, the risk of recurrence may be higher in patients with associated anomalies, particularly Down syndrome. Given the small sample size and retrospective design, these results should be interpreted with caution. Larger, multicenter prospective studies are warranted to validate these observations and establish definitive guidelines for surgical approach selection.

Citation:
Tığlı T, Soyer T, Boybeyi Ö. Comparison of laparoscopic transfascial knot tying and open repair of Morgagni hernia. Turkish J Ped Surg 2026;40(1):8-15. https:// doi.org/10.62114/JTAPS.2026.216.