Thoracoscopic Repair in the Neonatal Intensive Care Unit for Congenital Diaphragmatic Hernia During High-Frequency Oscillatory Ventilation

Aim: The aim of this work was to report the technique and result of thoracoscopic repair for a newborn with congenital diaphragmatic hernia (CDH) under high-frequency oscillatory ventilation (HFOV) in the neonatal intensive care unit (NICU).

Methods: Ventilation was supported by HFOV. The patient was placed in the right lateral decubitus position. Thoracoscopic surgery was performed through three 5-mm trocars. Carbon dioxide insufflation was maintained in the thoracic cavity at a pressure of 6–8 mm Hg. The hernia defect was repaired by using interrupted sutures with extracorporeal knots.

Results: The operation lasted 60 minutes. The intraoperative course was uneventful. Normal vital signs and PO₂ value were maintained throughout the operation. The patient had a normal chest X-ray 1 month after discharge.

Conclusion: Thoracoscopic repair of CDH in the NICU during HFOV is feasible and safe.