Simran K Randhawa, MD1, Charles Bakhos, MD, FACS2. 1Albert Einstein Healthcare Network, 2Temple University Lewis Katz School of Medicine
INTRODUCTION: Hemidiaphragm eventration is a rare anomaly and can be congenital or more commonly acquired as a result of trauma, neoplasms, infection, degenerative disease, or idiopathic. Surgical treatment is indicated in the presence of symptoms and diaphragmatic plication is the surgical treatment of choice.
METHODS: We present the case of a 35-year-old female who presented with shortness of breath and left upper quadrant pain. Fluoroscopy sniff test showed left hemidiaphragm paralysis with paradoxical motion and CT scan of the chest was suspicious for left hemidiaphragm eventration. Thus, a robotic assisted primary plication of the left hemidiaphragm was performed.
RESULTS: Minimally invasive approaches to diaphragm plication for eventration include thoracoscopic, laparoscopic and robotic assisted techniques. We report our approach using robotic assistance with the da Vinci Si Surgical System, (Intuitive Surgical Inc.) to perform primary plication of left hemidiaphragm eventration. We decided to go through the abdomen to minimize any inadvertant injury to the bowel. Since the surgery, she has exhibited significant improvement in her left upper quadrant pain and dyspnea.
CONCLUSION: Robotic-assisted diaphragm plication for unilateral diaphragm eventration can avoid single-lung ventilation, enable excellent visualization, and allow for precise placement of plication sutures to achieve maximum plication.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 93361
Program Number: V283
Presentation Session: Video Loop Day 2
Presentation Type: VideoLoop