Combined laparoscopic and thoracoscopic repair of adult right-sided Bochdalek hernia with massive liver prolapse: A case report

Figure 1 Chest radiograph. A chest radiograph showed elevation of the right hemidiaphragm.

Figure 2 Computed tomography of the thorax and abdomen. A: Axial view; B: Coronal view; C: Sagittal view. Computed tomography reveals prolapse of multiple intraabdominal organs into the right thoracic cavity, corresponding to a right-sided Bochdalek hernia. The herniated organs include the stomach, transverse colon, gallbladder, and left lobe of the liver.

Figure 3 Surgical findings. A and B: The stomach, transverse colon, greater omentum, liver, and gallbladder are herniated into the thoracic cavity via the diaphragmatic defect; C: The left lobe of the liver is completely trapped in the thoracic cavity; D: The diaphragmatic defect is found to be 10 cm × 8 cm; E: The diaphragmatic defect is closed using interrupted sutures; F: The sutured site is reinforced with Bard Composix E/X Mesh^®.