الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Congenital diaphragmatic hernia (CDH) is a congenital defect in diaphragm development, occurring in approximately 1 in 2500 newborns. CDHs occur mainly during the eighth to the tenth weeks of fetal life. They consist of Bochdalek, Central and Morgagni hernias. The cardinal aspects of CDH pathophysiology are pulmonary hypertension with persistence of a fetal circulatory pattern, along with a reduction in both pulmonary tidal volume and compliance. The intensity of such manifestations varies greatly, going from almost nonexistent to incompatible with life, depending on the severity of the anatomical abnormalities of a given patient Approximately 90% of the patients with CDH are symptomatic within the first 24 hours of life. Yet, this disease can first manifest at any age and, more rarely, go unnoticed until late in life, or even never be diagnosed. Following birth, a plain chest radiograph is almost always enough to confirm the diagnosis. The typical image is that of bowel loops seen within the lung fields, with deviation of the mediastinum to the contralateral side of the hernia, and decrease or absence of gas in the abdomen. Following a period of preoperative stabilization and optimization; patients with CDH are traditionally repaired surgically via a laparotomy which is the standard approach or thoracotomy. CDH patients treated by MIS should benefit from less pain and incisional complications, avoidance of the sequelae of thoracotomy or laparotomy, and reduced surgical stress compared with traditional open repair, although there are specific disadvantages mainly from CO2 absorption during insufflation, yet improved recently with lower CO2 pressure and better quality of insufflation.