Laparoscopic Repair of Morgagni Diaphragmatic Hernia in Children: Technical Challenges and Results
Bibliographic record
Abstract
Purpose: We report our preliminary experience with laparoscopic repair of anterior midline (Morgagni) diaphragmatic hernia and identify technical issues. Methods: Four consecutive children undergoing laparoscopic Morgagni hernia repair over 3 years were reviewed. Results: The ages ranged from 13 months to 13 years. Three were found incidentally, and one presented with sudden onset of left side chest pain; none had obstructive symptoms. At operation the hernia contained omentum in all cases and bowel in three cases. All four underwent primary laparoscopic repair with interrupted nonabsorbable sutures. A small residual eventration was left along the edge of the pericardium in the one patient with a sac. The patient who presented with chest pain was found grossly and histologically to have acute appendicitis within the left chest, requiring dissection of the inflamed viscera from the mediastinum and chest wall; laparoscopic appendectomy was also done. Median time to full diet was 3 days, morphine was given for a median of 36 hours, and median postoperative hospital stay was 4.5 days. There were no complications, and no cases were converted. Followup chest radiograph demonstrated complete resolution of the hernia in three patients, and a small amount of residual bowel in the unrepaired pericardial portion of the eventration in the other patient. All children remain clinically well. Conclusion: Laparoscopic repair of Morgagni diaphragmatic hernia in children is a safe technique that provides rapid recovery and superior cosmetic results. Many unexpected technical challenges can be managed effectively without converting to an open approach.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".