Figure 2

Human CDH. View of a human CDH during thoracoscopic surgical repair. The image is obtained through the scope, from the chest (i.e. above) and with the infant rotated on the operating table. Hence, the image is slightly rotated and left-right reversed with respect to other figures within this report. The retroperitoneum and spleen are visualized through the defect. Note that (i) the diaphragm anteriorly is intact, (ii) the defect extends to the body (chest) wall (dashed line) in the posterolateral position (solid arrows), and (iii) in the posteromedial position, a rim of diaphragm is present (open arrows). Thus surgical closure of the defect involves apposing diaphragm to chest wall laterally but diaphragm to diaphragm medially [22]. Larger defects may not be amenable to primary closure and generally are repaired with a prosthetic patch. Anterior (ANT), posterior (POST), medial (MED), and lateral (LAT). (Image courtesy of Dr. Edmund Yang, Vanderbilt Children's Hospital, Nashville, TN, USA.)