Reconstruction of a functional hemidiaphragm with use of omentum and latissimus dorsi flaps

After ablative surgery that involves the diaphragm, autologous tissue is the material of choice for reconstruction--particularly if adjuvant radiotherapy is planned. Latissimus dorsi muscle and omentum are reliable sources of such tissue. A case is reported describing a method of diaphragm reconstruction after resection by mobilization of the upper latissimus dorsi and passing the free muscle portion over the residual costal margin to form a neodiaphragmatic leaflet. Suture of the transposed latissimus free end to the residual diaphragm tendon and the use of omentum to fill defects residual after muscle transposition were used to complete the reconstruction.