Concurrent dual-scopic management of diaphragm disease

With the increasing appliance of minimally invasive approaches in both thoracic and general surgery, more and more diaphragmatic conditions are being managed with laparoscopy or thoracoscopy. Which one is adopted depends on the disease, facility support and surgeon's preference. However, in difficult scenarios such as adhesions, uncertain tumour location or bulky herniated organs, addition of another approach could be beneficial. Here we describe 2 cases, one with metastatic tumours within the diaphragm and another with diaphragmatic hernia in which concurrent thoracoscopic and laparoscopic, so-called dual-scopic, management was performed.