Fig. 2
a Intraoperative views obtained upon laparotomy and port positions for abdominal access. b A large hernial orifice is observed in the left diaphragm, and the prolapsed stomach, small intestine, colon, and pancreas, are seen in the left thoracic cavity. c The spleen is entirely contained within the thoracic cavity due to adhesions. d Upon complete exposure, the hernial orifice is found to be 10 × 8 cm, without hernia sac. e The diaphragmatic defect is closed with interrupted nonabsorbable sutures. f The sutured site was reinforced with Ventralight™ ST mesh