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Thoracoscopic Diaphragmatic Plication
Chapter 1 of 1 · Surgical Management
Plication technique
Thoracoscopic Diaphragmatic Plication Technique
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Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
The patient is a 12-year-old girl with Rett syndrome and severe pulmonary morbidity with recurrent admissions for left-sided pneumonia.
A severe eventration of the left diaphragm was present in this patient.
The procedure is performed in the right lateral decubitus position with carbon dioxide insufflation to a pressure of 6 millimeters of mercury.
Lung isolation is not used in this thoracoscopic diaphragmatic plication procedure.
Orole sutures take big bites of the diaphragm on each side of the eventration.
Each plicating suture approximates the diaphragmatic margins, pushing the weakened component inferiorly.
The suture is tied extracorporeally and cut long.
The second suture is placed approximately 1 centimeter away from the first.
A clip is placed on the tight suture to allow the plication site to be identified on a chest X-ray.
Plication continues from lateral to medial.
The diaphragmatic redundancy and eventration have been completely addressed by the plication.