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Thoracoscopic diaphragm plication
1Department of Cardiothoracic Surgery, James Cook University Hospital, Middlesbrough, UK joeldunning@doctors.org.uk.
Interactive Cardiovascular and Thoracic Surgery
|February 26, 2015
Summary
Diaphragm plication via video-assisted thoracoscopic surgery (VATS) can be challenging. This study presents a technique using carbon dioxide insufflation and specialized instruments to overcome barriers in VATS diaphragm plication for improved patient outcomes.
Area of Science:
- Thoracic Surgery
- Minimally Invasive Surgery
Background:
- Diaphragm plication is a crucial thoracic surgery for phrenic nerve injury patients experiencing dyspnea.
- Video-assisted thoracoscopic surgery (VATS) offers a less invasive approach, but presents implementation challenges.
Purpose of the Study:
- To present a simplified technique for VATS diaphragm plication.
- To address technical barriers associated with endoscopic diaphragm suturing.
Main Methods:
- Utilized carbon dioxide insufflation to enlarge the hemithorax and reduce diaphragmatic tension.
- Employed an Endostitch device for straightforward pledgeted suturing.
- Introduced a novel endograsper for improved diaphragm manipulation at various angles.
Main Results:
- The described method effectively overcomes challenges of port entry and suturing in VATS diaphragm plication.
- Carbon dioxide insufflation and specialized instruments facilitate precise suture placement on the diaphragm.
Conclusions:
- This technique simplifies VATS diaphragm plication, making it more accessible.
- The approach enhances the feasibility and safety of endoscopic diaphragm repair for patients with shortness of breath.
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