Delayed traumatic diaphragmatic hernias are rare, particularly those diagnosed decades after the initial trauma. We report a case of a right-sided diaphragmatic hernia that was identified 36 years after a blunt thoracic injury and successfully treated using a combined thoracoscopic and laparoscopic approach. A 78-year-old woman presented with progressive respiratory distress. Computed tomography revealed herniation of the small intestine and right colon through a posterior diaphragmatic defect into the right thoracic cavity. Thoracoscopic and laparoscopic procedures enabled safe adhesiolysis and closure of the hernia orifice. The postoperative course was uneventful, and the patient's respiratory distress improved markedly. While both thoracic and abdominal approaches are viable for diaphragmatic hernia repair, a combined approach provided enhanced visualization and safety in this complex case. This report highlights the feasibility and benefits of a minimally invasive combined approach in the management of delayed traumatic diaphragmatic hernias.
{"title":"Safe Repair of a Delayed Right-Sided Traumatic Diaphragmatic Hernia Using Combined Thoracoscopy and Laparoscopy: A Case Report","authors":"Hiroaki Hashimoto, Yoshihiro Miyazaki, Keisuke Kuroda, Naohiro Kobayashi, Yohei Owada, Hiromitsu Nakahashi, Tomoaki Furuta, Osamu Shimomura, Kazuhiro Takahashi, Shuntaro Tsukamoto, Kinji Furuya, Koichi Ogawa, Yoshimasa Akashi, Shinji Hashimoto, Tsuyoshi Enomoto, Tatsuya Oda","doi":"10.1111/ases.70166","DOIUrl":"10.1111/ases.70166","url":null,"abstract":"<p>Delayed traumatic diaphragmatic hernias are rare, particularly those diagnosed decades after the initial trauma. We report a case of a right-sided diaphragmatic hernia that was identified 36 years after a blunt thoracic injury and successfully treated using a combined thoracoscopic and laparoscopic approach. A 78-year-old woman presented with progressive respiratory distress. Computed tomography revealed herniation of the small intestine and right colon through a posterior diaphragmatic defect into the right thoracic cavity. Thoracoscopic and laparoscopic procedures enabled safe adhesiolysis and closure of the hernia orifice. The postoperative course was uneventful, and the patient's respiratory distress improved markedly. While both thoracic and abdominal approaches are viable for diaphragmatic hernia repair, a combined approach provided enhanced visualization and safety in this complex case. This report highlights the feasibility and benefits of a minimally invasive combined approach in the management of delayed traumatic diaphragmatic hernias.</p>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12527593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The purpose of this study is to evaluate the reproductive outcomes, including pregnancy rates and modes of delivery, in women of reproductive age who previously underwent vaginal natural orifice transluminal endoscopic surgery (vNOTES).
Data Sources
A literature search was conducted using PubMed, Scopus, Web of Science, and EBSCO databases. The review used topic-specific keywords and MeSH terms such as (“transvaginal tissue removal” OR “Natural Orifice Transluminal Endoscopic Surgery” OR “transvaginal tissue extraction” OR “transvaginal specimen extraction” OR NOTES OR vNOTES) AND (delivery OR childbirth OR birth).
Method Study Selection
All English-language articles focusing on vNOTES in women of reproductive age (18–45), with a uterus, and desiring to conceive were included. Studies were excluded if they involved bowel or gynecological malignancies, prior total hysterectomy, nonuse of posterior colpotomy for tissue removal, animal studies, or were not in English.
Tabulation, Integration, and Results
The quality of included studies was assessed using the Nonrandomized Studies of Interventions (ROBINS-I) tool. Five studies out of 66 159 were included—four retrospective and one case series—encompassing 903 patients who underwent vNOTES for various procedures. These included laparoscopic and minimally invasive surgeries, such as cholecystectomy, appendectomy, gastric sleeve, intestinal operations, and gynecological procedures. Of these, 180 became pregnant: 12 had miscarriages, 47 had vaginal births, and 32 had C-sections (15 elective, five due to prior C-section). Fifty-eight used Assisted Reproductive Treatment (ART). No cases of sexual dysfunction, vaginal pain, laceration, or shortening were reported.
Conclusion
The findings suggest that vNOTES is a safe surgical approach for women wishing to conceive, as it does not negatively impact fertility or childbirth. Mode of delivery is influenced more by obstetric indications than by a history of vNOTES.
Trial Registration: Registered in PROSPERO (CRD420250644811)
目的：本研究的目的是评估育龄妇女曾接受阴道自然口腔内内镜手术（vNOTES）的生殖结局，包括妊娠率和分娩方式。数据来源：使用PubMed、Scopus、Web of Science和EBSCO数据库进行文献检索。该综述使用了特定主题的关键词和MeSH术语，如（“经阴道组织切除”或“自然孔腔内窥镜手术”或“经阴道组织提取”或“经阴道标本提取”或NOTES或vNOTES）和（分娩或分娩或分娩）。方法研究选择：纳入所有育龄妇女（18-45岁）有子宫、有怀孕意愿的vNOTES英文文章。如果研究涉及肠或妇科恶性肿瘤、既往全子宫切除术、未使用后阴道切开术进行组织切除、动物研究或非英文研究则被排除。制表、整合和结果：采用非随机干预研究（ROBINS-I）工具评估纳入研究的质量。在66 159项研究中纳入了5项研究（4项回顾性研究和1项病例研究），包括903例因各种手术接受vNOTES的患者。其中包括腹腔镜手术和微创手术，如胆囊切除术、阑尾切除术、胃套管手术、肠道手术和妇科手术。其中，180人怀孕：12人流产，47人顺产，32人剖腹产（15人是自愿的，5人是因为之前剖腹产）。58人使用辅助生殖治疗（ART）。没有性功能障碍、阴道疼痛、撕裂或缩短的病例报道。结论：研究结果表明，vNOTES对于希望怀孕的女性来说是一种安全的手术方法，因为它不会对生育能力或分娩产生负面影响。分娩方式受产科指征的影响大于vNOTES病史的影响。试验报名：在PROSPERO注册（CRD420250644811）。
{"title":"The Effect of Posterior Colpotomy on Type of Delivery After Natural Orifice Specimen Extraction: A Systematic Review","authors":"Cihan Kaya, Hussein AlAli, Tugba Saka","doi":"10.1111/ases.70160","DOIUrl":"10.1111/ases.70160","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The purpose of this study is to evaluate the reproductive outcomes, including pregnancy rates and modes of delivery, in women of reproductive age who previously underwent vaginal natural orifice transluminal endoscopic surgery (vNOTES).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Sources</h3>\u0000 \u0000 <p>A literature search was conducted using PubMed, Scopus, Web of Science, and EBSCO databases. The review used topic-specific keywords and MeSH terms such as (“transvaginal tissue removal” OR “Natural Orifice Transluminal Endoscopic Surgery” OR “transvaginal tissue extraction” OR “transvaginal specimen extraction” OR NOTES OR vNOTES) AND (delivery OR childbirth OR birth).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method Study Selection</h3>\u0000 \u0000 <p>All English-language articles focusing on vNOTES in women of reproductive age (18–45), with a uterus, and desiring to conceive were included. Studies were excluded if they involved bowel or gynecological malignancies, prior total hysterectomy, nonuse of posterior colpotomy for tissue removal, animal studies, or were not in English.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Tabulation, Integration, and Results</h3>\u0000 \u0000 <p>The quality of included studies was assessed using the Nonrandomized Studies of Interventions (ROBINS-I) tool. Five studies out of 66 159 were included—four retrospective and one case series—encompassing 903 patients who underwent vNOTES for various procedures. These included laparoscopic and minimally invasive surgeries, such as cholecystectomy, appendectomy, gastric sleeve, intestinal operations, and gynecological procedures. Of these, 180 became pregnant: 12 had miscarriages, 47 had vaginal births, and 32 had C-sections (15 elective, five due to prior C-section). Fifty-eight used Assisted Reproductive Treatment (ART). No cases of sexual dysfunction, vaginal pain, laceration, or shortening were reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings suggest that vNOTES is a safe surgical approach for women wishing to conceive, as it does not negatively impact fertility or childbirth. Mode of delivery is influenced more by obstetric indications than by a history of vNOTES.</p>\u0000 \u0000 <p><b>Trial Registration:</b> Registered in PROSPERO (CRD420250644811)</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Response to the Letter to the Editor Regarding: Short-Term and 3-Year Oncological Outcomes in Laparoscopic-Assisted Trans-Anal Pelvic Exenteration With Preserving Anal Sphincter for Locally Advanced Rectal Cancer","authors":"Takashi Nonaka, Tetsuro Tominaga, Toshio Shiraishi, Shintaro Hashimoto, Keisuke Noda, Terumitsu Sawai, Keitaro Matsumoto","doi":"10.1111/ases.70163","DOIUrl":"10.1111/ases.70163","url":null,"abstract":"","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 66-year-old man visited our hospital because of swelling and pain in both inguinal regions. He had previously undergone femoral-femoral artery bypass for peripheral artery disease and was taking antiplatelet medication. Abdominal surgery for patients with a history of nonanatomic bypass carries the risk of wound limitation due to artificial vessels, vascular injury, and infection. Laparoscopic hernia repair is a preperitoneal approach that is considered to be free of these risks, and intraoperative manipulation is considered to have little negative influence. In this study, we performed laparoscopic hernia repair for bilateral inguinal hernias after femoral-femoral arterial bypass on antiplatelet therapy. There were no perioperative complications, and the patient had no recurrence in 6 months.
{"title":"A Case of TAPP (Transabdominal Preperitoneal Repair) for Bilateral Inguinal Hernias After Femoral-Femoral Artery Bypass on Antiplatelet Therapy","authors":"Makoto Uchino, Tsunehiko Maruyama, Chiaki Tanaka, Yusuke Ozawa, Reiji Nozaki, Tatsuya Oda","doi":"10.1111/ases.70164","DOIUrl":"10.1111/ases.70164","url":null,"abstract":"<div>\u0000 \u0000 <p>A 66-year-old man visited our hospital because of swelling and pain in both inguinal regions. He had previously undergone femoral-femoral artery bypass for peripheral artery disease and was taking antiplatelet medication. Abdominal surgery for patients with a history of nonanatomic bypass carries the risk of wound limitation due to artificial vessels, vascular injury, and infection. Laparoscopic hernia repair is a preperitoneal approach that is considered to be free of these risks, and intraoperative manipulation is considered to have little negative influence. In this study, we performed laparoscopic hernia repair for bilateral inguinal hernias after femoral-femoral arterial bypass on antiplatelet therapy. There were no perioperative complications, and the patient had no recurrence in 6 months.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluating Laparoscopic-Assisted Transanal Pelvic Exenteration for Locally Advanced Rectal Cancer and Its Future Directions","authors":"Faisal A. Shaikh, Rahul Narang, Zoltan H. Nemeth","doi":"10.1111/ases.70155","DOIUrl":"10.1111/ases.70155","url":null,"abstract":"","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Von Hippel-Lindau disease (VHL) is a hereditary multiorgan cancer syndrome; however, liver tumors are rarely encountered. Herein, we present a case of slow-growing primary hepatic carcinosarcoma associated with VHL that was curatively treated laparoscopically. A 37-year-old woman has regularly visited the neurosurgery department of our hospital with VHL-associated cerebellar and medullary hemangioblastomas. Computed tomography performed 6 years earlier revealed a 20-mm solitary hypervascular tumor with cystic components in liver segment 3. The tumor size was stable for a while but had been steadily growing over the past few years and was 55 mm at the time of referral to our department. Because increased uptake on 18F-FDG-PET suggested malignancy, such as hemangioblastoma or neuroendocrine tumor, laparoscopic left hepatectomy was performed without percutaneous biopsy, considering the potential risk of tumor cell seeding. Histopathological examination revealed carcinosarcoma, and no recurrence was noted at the 1-year follow-up.
Von Hippel-Lindau病（VHL）是一种遗传性多器官癌症综合征；然而，肝脏肿瘤是罕见的。在此，我们报告一例生长缓慢的原发性肝癌肉瘤合并VHL，经腹腔镜治疗。一名37岁女性因vhl相关的小脑和髓质血管母细胞瘤定期到我院神经外科就诊。6年前的计算机断层扫描显示在肝3节段有一个20毫米的孤立性高血管肿瘤伴囊性成分。肿瘤大小在一段时间内稳定，但在过去几年中稳步增长，在转介到我科时为55mm。由于18F-FDG-PET摄取增加提示恶性肿瘤，如血管母细胞瘤或神经内分泌肿瘤，考虑到肿瘤细胞播散的潜在风险，腹腔镜左肝切除术不经皮穿刺活检。组织病理学检查显示为癌肉瘤，随访1年未见复发。
{"title":"Laparoscopic Left Hepatectomy for Slowly Progressing Primary Hepatic Carcinosarcoma Associated With Von Hippel-Lindau Disease","authors":"Takao Tsukahara, Masatoshi Kajiwara, Katsudai Shirakabe, Takahide Sasaki, Ryo Nakashima, Shigetoshi Naito, Yoshihiro Hamada, Suguru Hasegawa","doi":"10.1111/ases.70162","DOIUrl":"10.1111/ases.70162","url":null,"abstract":"<div>\u0000 \u0000 <p>Von Hippel-Lindau disease (VHL) is a hereditary multiorgan cancer syndrome; however, liver tumors are rarely encountered. Herein, we present a case of slow-growing primary hepatic carcinosarcoma associated with VHL that was curatively treated laparoscopically. A 37-year-old woman has regularly visited the neurosurgery department of our hospital with VHL-associated cerebellar and medullary hemangioblastomas. Computed tomography performed 6 years earlier revealed a 20-mm solitary hypervascular tumor with cystic components in liver segment 3. The tumor size was stable for a while but had been steadily growing over the past few years and was 55 mm at the time of referral to our department. Because increased uptake on <sup>18</sup>F-FDG-PET suggested malignancy, such as hemangioblastoma or neuroendocrine tumor, laparoscopic left hepatectomy was performed without percutaneous biopsy, considering the potential risk of tumor cell seeding. Histopathological examination revealed carcinosarcoma, and no recurrence was noted at the 1-year follow-up.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chika Franklin Chilaka, Hafsa Riaz, Muhammad Kashif, Maham Ejaz, Mirza M. Hadeed Khawar
{"title":"Critical Evaluation of Safety Claims and Statistical Validity in Delayed Laparoscopic Cholecystectomy With Fluorescent Cholangiography","authors":"Chika Franklin Chilaka, Hafsa Riaz, Muhammad Kashif, Maham Ejaz, Mirza M. Hadeed Khawar","doi":"10.1111/ases.70156","DOIUrl":"10.1111/ases.70156","url":null,"abstract":"","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nabil Mohammad Azmi, Firdaus Hayati, Zairul Azwan Mohd Azman, Ismail Sagap
{"title":"Comments on: Effectiveness of Cleaning the Laparoscopic Lens With a Novel Microfiber Cloth During Laparoscopic Colorectal Cancer Surgery: A Prospective Randomized Controlled Trial","authors":"Nabil Mohammad Azmi, Firdaus Hayati, Zairul Azwan Mohd Azman, Ismail Sagap","doi":"10.1111/ases.70161","DOIUrl":"10.1111/ases.70161","url":null,"abstract":"","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mehmet Baki Şentürk, Mehmet Kulhan, Ahmet Bilgi, Cihan Kaya, Murat Yassa, Ozan Doğan
Intrauterine device (IUD) migration is a rare complication that may necessitate surgical removal, typically via laparoscopy. With advancements in endoscopic surgery, vaginal natural orifice transluminal endoscopic surgery (vNOTES) offers a scarless and minimally invasive alternative. A 27-year-old woman (G2P2) with a history of IUD placement 4 years ago was diagnosed with an ectopic IUD in the right adnexa. vNOTES was performed under general anesthesia using the vPORT system (Ankalap, Biomicro Turkiye) for transvaginal access. The IUD was safely removed without complications. This case highlights the feasibility and safety of vNOTES for migrated IUD retrieval, offering a cosmetically superior and effective alternative to traditional laparoscopy.
{"title":"Vaginal Natural Orifice Transluminal Endoscopic Removal of a Migrated Intrauterine Device Using the vPORT System","authors":"Mehmet Baki Şentürk, Mehmet Kulhan, Ahmet Bilgi, Cihan Kaya, Murat Yassa, Ozan Doğan","doi":"10.1111/ases.70158","DOIUrl":"10.1111/ases.70158","url":null,"abstract":"<div>\u0000 \u0000 <p>Intrauterine device (IUD) migration is a rare complication that may necessitate surgical removal, typically via laparoscopy. With advancements in endoscopic surgery, vaginal natural orifice transluminal endoscopic surgery (vNOTES) offers a scarless and minimally invasive alternative. A 27-year-old woman (G2P2) with a history of IUD placement 4 years ago was diagnosed with an ectopic IUD in the right adnexa. vNOTES was performed under general anesthesia using the vPORT system (Ankalap, Biomicro Turkiye) for transvaginal access. The IUD was safely removed without complications. This case highlights the feasibility and safety of vNOTES for migrated IUD retrieval, offering a cosmetically superior and effective alternative to traditional laparoscopy.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Coexistence of congenital diaphragmatic eventration (CDE) and an intrathoracic ectopic kidney (ITEK) is extremely rare and may lead to substantial respiratory distress in neonates. This study reports the case of a small-for-gestational-age male neonate presenting with respiratory distress and requiring nasal continuous positive airway pressure. Computed tomography revealed right-sided CDE accompanied by an ITEK. At 44 days old, the infant underwent thoracoscopic diaphragmatic plication. CO2 insufflation during surgery led to spontaneous reduction of the ectopic kidney into the abdominal cavity, eliminating the need for direct manipulation. The postoperative course was uneventful, and at 14 months, the child remains healthy with no signs of recurrence. This case demonstrates that thoracoscopic plication is a safe and effective option for managing this rare condition, even in low-birth-weight infants. It also suggests that the ectopic position of the kidney is a secondary consequence of diaphragmatic laxity.
{"title":"Thoracoscopic Plication for Neonatal Diaphragmatic Eventration With Intrathoracic Ectopic Kidney: A Rare Case Report","authors":"Eunyoung Jung","doi":"10.1111/ases.70157","DOIUrl":"10.1111/ases.70157","url":null,"abstract":"<div>\u0000 \u0000 <p>Coexistence of congenital diaphragmatic eventration (CDE) and an intrathoracic ectopic kidney (ITEK) is extremely rare and may lead to substantial respiratory distress in neonates. This study reports the case of a small-for-gestational-age male neonate presenting with respiratory distress and requiring nasal continuous positive airway pressure. Computed tomography revealed right-sided CDE accompanied by an ITEK. At 44 days old, the infant underwent thoracoscopic diaphragmatic plication. CO<sub>2</sub> insufflation during surgery led to spontaneous reduction of the ectopic kidney into the abdominal cavity, eliminating the need for direct manipulation. The postoperative course was uneventful, and at 14 months, the child remains healthy with no signs of recurrence. This case demonstrates that thoracoscopic plication is a safe and effective option for managing this rare condition, even in low-birth-weight infants. It also suggests that the ectopic position of the kidney is a secondary consequence of diaphragmatic laxity.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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