Single transversus abdominis muscle flap: Another possibility for large congenital diaphragmatic hernia repair

Large defect congenital diaphragmatic hernias comprise a defect too large to be closed primarily and diaphragm agenesis. This condition remains a surgical and intensive care challenge. Many different approaches have been described. Prosthetic patches are often used, but they face the major issue of high recurrence rate ranging from 27 to 50%. Some reports in the literature describe muscle flap repair and though they are scarce and concern small series, they indicate that muscle flaps recur only in 0 to 4.3%3,4 . For the last 20 years, our routine clinical practice has been to avoid patches by using a muscle flap to repair the defects that are too large for primary closure. We therefore present a simple novel technique using a single layer muscle flap based on the transversus abdominis muscle