title: Video assisted thoracoscopic plication of the left hemidiaphragm in symptomatic eventration in adulthood.
abstract: Diaphragmatic eventration is a rare congenital developmental defect of the muscular portion of the diaphragm, which appears attenuated and membranous, maintaining its normal attachments and its anatomical continuity. It has been attributed to abnormal myoblast migration to the septum transversum and the pleuroperitoneal membrane. Eventration can be unilateral or bilateral, partial or complete. It is more common in males, and involves more often the left hemidiaphragm. Eventration results in diaphragmatic elevation (cephalad displacement). Most adults are asymptomatic and the diagnosis is incidentally made by chest radiography. The commonest symptom in the adults is dyspnoea, while orthopnoea, mild hypoxemia, tachypnoea, respiratory alkalosis, palpitations, and non specific gastrointestinal symptoms may be present. Surgery is indicated only in the presence of symptoms. The established surgical treatment is diaphragmatic plication. Various techniques and approaches have been employed. We present a simple surgical technique of a 3-port video assisted thoracoscopic plication of the left hemidiaphragm in the adult.
authors.affiliation: Cardiothoracic Department, St Luke's Hospital, Panorama, Thessaloniki, Greece;
authors.forename: Aikaterini N
authors.initials: AN
authors.lastname: Visouli
authors.forename: Andreas
authors.initials: A
authors.lastname: Mpakas
authors.forename: Paul
authors.initials: P
authors.lastname: Zarogoulidis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Machairiotis
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Stylianaki
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Katsikogiannis
authors.forename: Kosmas
authors.initials: K
authors.lastname: Tsakiridis
authors.forename: Nicolaos
authors.initials: N
authors.lastname: Courcoutsakis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Zarogoulidis
keywords: Diaphragmatic eventration; diaphragm/ surgery; diaphragmatic eventration/surgery; thoracic surgical procedures/methods; thoracoscopy