Congenital diaphragmatic hernia repair: Patches, muscle flaps, and the search for the ideal technique

jpedsurg.org

There is a variable defect size in both left and right-sided congenital diaphragmatic hernia. The majority can be repaired using primary apposition but in a significant minority this will not be possible. A number of surgical techniques have been developed to overcome this problem but in principle these can be divided into the creation of a muscle flap usually derived from layers of the abdominal wall rotated into the gap or the insertion of a prosthetic patch. The composition of the latter has also been subject to variation and has been largely non-absorbable or absorbable and dependent on surgical preference.

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Article · Oct 2025 · 1 min read

In brief

This article reviews surgical approaches for repairing congenital diaphragmatic hernias when primary closure is not feasible due to large defect size. It compares muscle flap techniques using abdominal wall layers versus prosthetic patch insertion, examining the advantages of absorbable and non-absorbable materials in pediatric reconstruction.

Most congenital diaphragmatic hernias can be repaired with primary closure, but a significant minority require alternative techniques.
When primary repair is not feasible, surgeons use either muscle flaps (rotated from abdominal wall) or prosthetic patches.
Prosthetic patches vary in composition (absorbable vs non-absorbable) based on surgeon preference, with no clear consensus on ideal material.

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