title: [Thoracoscopic diaphragmatic plication for eventration of diaphragm in children using no-knife automatic suturing device].
abstract: Diaphragm eventration could inhibit the lung development due to compression. Thus diaphragm plication is required for the diaphragm eventration to prevent lung compression causing lung immaturity. However, we sometimes encounter the difficulty in endoscopic plication for fragile diaphragm without damaging it in narrow thoracic space in children. We demonstrate the plication using no-knife automatic suturing device.
  
  
  METHODS
  Two linear ridges are made using stapler on the flaccid diaphragm without cutting the tissue. Then the created 2 ridges are sutured so that the diaphragm is plicated.
  
  
  RESULTS
  Once the stapler was applied to make 2 linear ridges, we easily sutured and gathered them without checking the damage of the intra-abdominal organs. Furthermore, reinforced ridges could be plicated without damaging the fragile diaphragm. We conclude that above described method is preferable for the diaphragm eventration in pediatric patients with fragile diaphragm and limited thoracic space.
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Yamanashi, Chuo, Japan.
authors.forename: Hirochika
authors.initials: H
authors.lastname: Matsubara
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Miyauchi
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Ichihara
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Matsuoka
authors.forename: Tamo
authors.initials: T
authors.lastname: Kunimitsu
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Uchida
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Onuki
authors.forename: Norio
authors.initials: N
authors.lastname: Hasuda
authors.forename: Noboru
authors.initials: N
authors.lastname: Oyachi
authors.forename: Kunio
authors.initials: K
authors.lastname: Takano
authors.forename: Shoji
authors.initials: S
authors.lastname: Suzuki
mesh_terms: D002648:Child; D003964:Diaphragm / Q000601:surgery*; D003965:Diaphragmatic Eventration / Q000601:surgery*; D006801:Humans; D008297:Male; D013528:Surgical Staplers; D013536:Suture Techniques / Q000295:instrumentation*