Xia ZL, Luo KC, Tang J, Sun L. Laparoscopic one-stage repair of concurrent Morgagni hernia and hiatus hernia: A case report and review of literature. World J Gastrointest Surg 2026; 18(10): 123093 [DOI: 10.4240/wjgs.123093]
Corresponding Author of This Article
Liang Sun, PhD, Associate Chief Physician, Professor, Department of Gastrointestinal and Hernia Surgery, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang Road, Wuhua District, Kunming 650032, Yunnan Province, China. xl1224999730@163.com
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Surgery
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case-report
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Xia ZL, Luo KC, Tang J, Sun L. Laparoscopic one-stage repair of concurrent Morgagni hernia and hiatus hernia: A case report and review of literature. World J Gastrointest Surg 2026; 18(10): 123093 [DOI: 10.4240/wjgs.123093]
World J Gastrointest Surg. Oct 27, 2026; 18(10): 123093 Published online Oct 27, 2026. doi: 10.4240/wjgs.123093
Laparoscopic one-stage repair of concurrent Morgagni hernia and hiatus hernia: A case report and review of literature
Ze-Lin Xia, Kai-Cheng Luo, Jie Tang, Liang Sun
Ze-Lin Xia, Liang Sun, Department of Gastrointestinal and Hernia Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan Province, China
Kai-Cheng Luo, Department of General Surgery, Xinping County People’s Hospital, Yuxi 653499, Yunnan Province, China
Jie Tang, Department of General Surgery, Qilin District People’s Hospital of Qujing, Qujing 655000, Yunnan Province, China
Author contributions: Xia ZL collected the clinical data, did the literature review and wrote the manuscript; Luo KC performed the surgical procedure and participated in the perioperative management and follow up of the patient; Tang J participated in data acquisition, prepared the surgical video vignette and helped to write the manuscript; Sun L performed the surgical procedure, conceived and supervised the study, and critically revised the manuscript for important intellectual content. All authors read and approved the final manuscript.
AI contribution statement: The authors take full responsibility and accountability for all content of this manuscript, including any portions for which AI tools were used as assistive technologies. All AI-assisted outputs were carefully reviewed, validated, and approved by the authors. AI tools were not used to generate original scientific data, perform independent scientific analyses, or draw scientific conclusions.
Supported by Yunnan Provincial Department of Science and Technology General Program, No. 202401AY070001-241.
Informed consent statement: The patient gave written informed consent for publication of this case report and any accompanying images and video vignette.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Liang Sun, PhD, Associate Chief Physician, Professor, Department of Gastrointestinal and Hernia Surgery, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang Road, Wuhua District, Kunming 650032, Yunnan Province, China. xl1224999730@163.com
Received: May 8, 2026 Revised: May 25, 2026 Accepted: June 15, 2026 Published online: October 27, 2026 Processing time: 158 Days and 0.5 Hours
Abstract
BACKGROUND
Morgagni hernia (MH) is a rare congenital diaphragmatic defect that is extremely rare when concomitant with hiatus hernia (HH), and there are only a few cases reported in the world literature. Surgical treatment is the definitive treatment for MH, and in clinical practice, laparoscopic surgery is the first line of minimally invasive approach for diaphragmatic hernia repair.
CASE SUMMARY
A 73-year-old female patient, with heartburn and occasional dry cough for one year, was thought to have gastroesophageal reflux disease. Preoperative imaging and endoscopic examinations were completed in a comprehensive way, and the diagnosis of right-sided MH, sliding HH, and non-atrophic gastritis was made. She underwent laparoscopic tension-free one-stage repair of both diaphragmatic hernias combined with 270-degree Toupet fundoplication under general anesthesia. The operation went smoothly. To ensure safe gastrointestinal recovery, the patient was kept nil per os with exclusive parenteral nutrition on postoperative day one. Water was permitted on day two, followed by a liquid diet on day three, at which point parenteral nutrition was completely discontinued. She returned to a normal diet within one week. At her 12-month follow-up, she reported zero reflux symptoms, and scans showed no recurrence.
CONCLUSION
Concurrent Morgagni and HHs are safely resolved by single-stage laparoscopic repair using biological mesh and Toupet fundoplication.
Core Tip: Concurrent Morgagni hernia and hiatus hernia is an extremely rare clinical condition with limited reported cases globally. Laparoscopic one-stage tension-free repair with biological mesh combined with 270° Toupet fundoplication is safe, minimally invasive and clinically effective. It achieves ideal anatomical reconstruction of diaphragmatic defects, fully alleviates patient symptoms and maintains excellent long-term outcomes, and no hernia recurrence was detected during regular follow-up.
