To Sink the Lifted: Selection, Technique, and Result of Laparoscopic Diaphragmatic Plication for Paralysis or Eventration

Thorac Cardiovasc Surg. 2016 Dec;64(8):631-640. doi: 10.1055/s-0035-1570372. Epub 2015 Dec 31.


Introduction Diaphragmatic 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. Discussion We 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. Conclusion Minimally 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.

Publication types

  • Review

MeSH terms

  • Diaphragm / abnormalities
  • Diaphragm / innervation
  • Diaphragm / surgery*
  • Diaphragmatic Eventration / complications
  • Diaphragmatic Eventration / diagnosis
  • Diaphragmatic Eventration / physiopathology
  • Diaphragmatic Eventration / surgery*
  • Dyspnea / etiology
  • Dyspnea / physiopathology
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / methods*
  • Patient Selection
  • Predictive Value of Tests
  • Quality of Life
  • Recovery of Function
  • Respiratory Paralysis / diagnosis
  • Respiratory Paralysis / etiology
  • Respiratory Paralysis / physiopathology
  • Respiratory Paralysis / surgery*
  • Risk Factors
  • Thoracic Surgical Procedures / adverse effects
  • Thoracic Surgical Procedures / methods*
  • Treatment Outcome