Diaphragmatic relaxation: pathophysiological alterations and current possibilities of surgical repair

Diaphragmatic relaxation is a pathology not frequently observed because it is generally oligosymptomatic. The development of modern technology has induced an important contribution to the diagnosis and treatment of the disease which can find a possibility of restoration in surgery. A 63-year-old patient with a light syndrome of respiration deficiency and an altered relaxed profile of the right cupola was subjected to surgical treatment with the technique of diaphragmatic plicature without any adverse implication during and after the operation. After a brief recovery, the patient was discharged and after 9 years he affirmed still absence of dyspnoea from limited labor and absence of respiration problems. The selected surgical technique for the restoration of the altered muscle is the diaphragmatic plicature without incision or excision of the altered part of the muscle. The preferable access way today is that of laparotomy which is devoid of problems of thoracotomy and generally it permits quite easily the restoration of all diaphragmatic defects. Diaphragmatic plicature is a simple, effective and long-lasting intervention but we cannot determine the complete recovery of the normal contractile function of the muscle. There is no morbidity and mortality directly related to this technique, the latter incidentally associated with complications of general anesthesia.