Urgent da Vinci-Assisted Laparoscopic Repair of an Incarcerated Adult Bochdalek Hernia Presenting With Large-Bowel Obstruction: A Case Report and Literature Review.

Bochdalek hernias (BHs) are a rare form of diaphragmatic hernia in adults. They are typically diagnosed in infancy or childhood; however, in rare cases, they may be discovered in completely asymptomatic adults. Because this condition is uncommon, it can be mistaken for other conditions and misdiagnosed, exposing patients to unnecessary treatments. We present the case of a 33-year-old man with a past medical history of hypertension who presented to the ED with a four-day history of severe abdominal pain, nausea, and vomiting. CT of the abdomen and pelvis with contrast showed findings consistent with a mechanical large-bowel obstruction secondary to an incarcerated BH containing the splenic flexure of the colon and omental fat. The patient was successfully treated using a da Vinci-assisted laparoscopic approach with mesh repair. At the three-month follow-up, the patient remained asymptomatic, without clinical signs of recurrence. In adults, a BH is an uncommon form of diaphragmatic hernia. As many cases are asymptomatic, a high index of suspicion is needed because diagnosis can be challenging. Modern surgical techniques can improve patient recovery and result in shorter hospital stays, with minimal morbidity and mortality. In this case report, we demonstrate that a robot-assisted laparoscopic approach was a safe and effective means of repairing this hernia and provide an overview of the current literature.