VATS Repair of Left Bochdalek Hernia

Complementary to a previous video describing repair of a right Bochdalek hernia, this video explains how to deal with a left one. The patient was a 46-year-old male who was very fit, but noticed deterioration in his level of stamina. He also noticed increasing shortness of breath lying flat. His spirometry was normal, but there was an 8% drop in his vital capacity when lying down from sitting position. A CT scan showed a fatty structure in the left chest reminiscent of greater omentum. This video describes how the author dealt with this congenital abnormality using a video-assisted thoracoscopic (VATS) approach. Symptomatic left Bochdalek hernia in an adult is very rare, but can be repaired via VATS. The thoracic surgeon must be prepared to stitch in a synthetic patch should the need arise.