title: Transperitoneal laparoscopic surgery using endostaplers for adult unilateral diaphragmatic eventration.
abstract: A 27-year-old woman was referred owing to elevation of the left diaphragm on a chest roentgenogram. Preoperative examinations revealed neither herniation nor incarceration of the digestive tracts into the thoracic cavity. A diagnosis of unilateral diaphragmatic eventration was made, and laparoscopic surgery was performed. Intraoperative findings revealed a partially thin diaphragm. Immediately after careful opening of the thoracic cavity, respiration was switched to selective right lung ventilation. The extended thin diaphragm was easily gripped. The whole layer of the diaphragm, including a pleural hole, was resected using an endostapler without involving the lung tissue at the normal thick diaphragm. This endostapling procedure was repeated until the desired tension was obtained, and a chest tube was then inserted. X-ray fluorographic views showed a functioning repaired diaphragm. The postoperative course was uneventful with normalization of the diaphragm. In this paper, we present our modified techniques of transperitoneal minimally invasive surgery for diaphragmatic eventration.
authors.affiliation: Department of Hepato-pancreato-biliary and Transplantation Surgery, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan. horit@kuhp.kyoto-u.ac.jp
authors.forename: Tomohide
authors.initials: T
authors.lastname: Hori
authors.forename: Koichi
authors.initials: K
authors.lastname: Masuda
authors.forename: Kentaro
authors.initials: K
authors.lastname: Taniguchi
authors.forename: Makoto
authors.initials: M
authors.lastname: Iwasaki
authors.forename: Hideko
authors.initials: H
authors.lastname: Kuzuhara
authors.forename: Shinya
authors.initials: S
authors.lastname: Okamoto
authors.forename: Shotaro
authors.initials: S
authors.lastname: Saegusa
authors.forename: Shintaro
authors.initials: S
authors.lastname: Yagi
authors.forename: Taku
authors.initials: T
authors.lastname: Iida
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
mesh_terms: D000328:Adult; D003964:Diaphragm / Q000601:surgery*; D003965:Diaphragmatic Eventration / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D019060:Minimally Invasive Surgical Procedures; D010537:Peritoneum / Q000601:surgery*; D017792:Surgical Stapling / Q000295:instrumentation* / Q000379:methods