Abstract：
We report the case of a 32-year-old man who developed a giant diaphragmatic hernia following the removal of a left ventricular assist device 4 years prior due to improved cardiac function. Chest radiography revealed an intrathoracic prolapse of the gastrointestinal tract. The patient was diagnosed with a diaphragmatic hernia and a laparoscopy-assisted repair was performed. A 12 × 8 cm hernia was found intraoperatively on the left diaphragm, and a large portion of the gastrointestinal tract had prolapsed into the thoracic cavity. We attempted to repair the ventromedial defect using mesh; however, it was found to be insufficient. Therefore, we used a left rectus abdominis myocutaneous flap to fill the defect and sutured it to the mesh. A myocutaneous flap could be a useful strategy in cases where complete closure with mesh is difficult.
摘要：
我们报告了一名32岁男子的病例，该男子在4年前由于改善了心脏功能而移除左心室辅助装置后，出现了巨大的膈疝。胸部X线检查显示胃肠道胸内脱垂。患者被诊断为膈疝，并进行了腹腔镜辅助修复。术中发现左膈疝12×8厘米，大部分胃肠道脱垂到胸腔。我们尝试使用网状物修复腹内侧缺损；然而，它被发现是不够的。因此,我们使用左腹直肌肌皮瓣填充缺损并缝合到网孔上。在难以用网状物完全闭合的情况下，肌皮瓣可能是有用的策略。
