title: To Sink the Lifted: Selection, Technique, and Result of Laparoscopic Diaphragmatic Plication for Paralysis or Eventration.
abstract: IntroductionDiaphragmatic eventration is a congenital defect of the muscular portion of a hemidiaphragm that eventually leads to hemidiaphragmatic elevation and dysfunction. The clinical diagnosis of diaphragmatic eventration or diaphragmatic paralysis may be indistinguishable and diaphragmatic plication is the treatment of choice for both conditions.DiscussionWe review the indications, patient selection, and surgical techniques for diaphragmatic plication. We explain our preferred technique and guide the reader step by step on our approach.ConclusionMinimally invasive diaphragm plication techniques are effective alternatives to open transthoracic plication and result in significant improvement in dyspnea and quality of life in adequately selected patients.
authors.affiliation: Department of Thoracic and Foregut Surgery, University of Minnesota, Minneapolis, Minnesota, United States.
authors.forename: Eitan
authors.initials: E
authors.lastname: Podgaetz
authors.affiliation: Department of Thoracic and Foregut Surgery, University of Minnesota, Minneapolis, Minnesota, United States.
authors.forename: Ilitch
authors.initials: I
authors.lastname: Diaz
authors.affiliation: Department of Thoracic and Foregut Surgery, University of Minnesota, Minneapolis, Minnesota, United States.
authors.forename: Rafael Santiago
authors.initials: RS
authors.lastname: Andrade
mesh_terms: D003964:Diaphragm / Q000002:abnormalities / Q000294:innervation / Q000601:surgery*; D003965:Diaphragmatic Eventration / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D004417:Dyspnea / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D018579:Patient Selection; D011237:Predictive Value of Tests; D011788:Quality of Life; D020127:Recovery of Function; D012133:Respiratory Paralysis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D012307:Risk Factors; D019616:Thoracic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome