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Related Concept Videos

Pneumothorax-II01:27

Pneumothorax-II

Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Flail Chest-II01:26

Flail Chest-II

Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:

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Related Experiment Video

Updated: May 28, 2026

Non-Intubated Video-Assisted Thoracoscopic Surgery
05:39

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Published on: May 26, 2023

Two-port Video-Assisted Thoracoscopic Plication Using Porous Nitinol Pledgets for Diaphragmatic Paralysis.

Evgeniy Topolnitskiy1,2, Timofey Chekalkin3, Ekaterina Marchenko2

  • 1Department of Surgery, Siberian State Medical University, Tomsk, Russia.

Surgical Innovation
|May 26, 2026
PubMed
Summary
This summary is machine-generated.

This study shows that a two-port video-assisted thoracoscopic surgery (VATS) diaphragmatic plication using Nitinol (NiTi) pledgets is a safe and effective treatment for diaphragmatic paralysis. Patients experienced significant improvements in lung function and reduced symptoms, demonstrating the technique

Keywords:
diaphragmatic plicationminimally invasive thoracic surgeryphrenic nerve paralysisporous nitinol pledgetsvideo-assisted thoracoscopic surgery

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Area of Science:

  • Thoracic Surgery
  • Minimally Invasive Procedures
  • Biomaterials in Surgery

Background:

  • Diaphragmatic plication is a standard treatment for symptomatic unilateral diaphragmatic paralysis.
  • Debate exists regarding the optimal minimally invasive technique and reinforcement materials.
  • Porous Nitinol (NiTi) pledgets offer a potential alternative to traditional reinforcement materials.

Purpose of the Study:

  • To evaluate the feasibility, safety, and efficacy of a two-port video-assisted thoracoscopic surgery (VATS) diaphragmatic plication technique.
  • To assess the functional and symptomatic outcomes using porous NiTi pledgets for reinforcement.
  • To determine the perioperative outcomes and complications associated with this technique.

Main Methods:

  • Retrospective single-center study of 30 adults with symptomatic unilateral diaphragmatic paralysis.
  • Procedures performed using a two-port VATS approach with porous NiTi pledgets and non-absorbable sutures.
  • Evaluation of perioperative (operative time, blood loss, extubation, ICU stay, chest tube duration, pain, complications, length of stay) and functional outcomes (spirometry, dyspnea scores, radiographic assessment) at 1, 6, and 12 months.

Main Results:

  • Mean operative time was 123.1 minutes with minimal blood loss (20.3 mL).
  • High rates of immediate extubation (86.7%) and low complication rates (13.3%, all grade I-II).
  • Significant improvements observed at 12 months: FVC increased by ~22%, FEV1 by ~21%, MRC dyspnea scores improved substantially, diaphragm elevation decreased by ~34%, and 90% reported symptomatic improvement.

Conclusions:

  • Two-port VATS diaphragmatic plication with porous NiTi pledgets is feasible, safe, and reproducible.
  • The technique leads to sustained functional and symptomatic improvements with low morbidity.
  • Porous NiTi pledgets provide a biocompatible option for reinforcement, contributing to mechanical restoration in diaphragmatic plication.