Transperitoneal laparoscopic surgery using endostaplers for adult unilateral diaphragmatic eventration.

Abstract

A 27-year-old woman was referred owing to elevation of the left diaphragm on a chest roentgenogram. Preoperative examinations revealed neither herniation nor incarceration of the digestive tracts into the thoracic cavity. A diagnosis of unilateral diaphragmatic eventration was made, and laparoscopic surgery was performed. Intraoperative findings revealed a partially thin diaphragm. Immediately after careful opening of the thoracic cavity, respiration was switched to selective right lung ventilation. The extended thin diaphragm was easily gripped. The whole layer of the diaphragm, including a pleural hole, was resected using an endostapler without involving the lung tissue at the normal thick diaphragm. This endostapling procedure was repeated until the desired tension was obtained, and a chest tube was then inserted. X-ray fluorographic views showed a functioning repaired diaphragm. The postoperative course was uneventful with normalization of the diaphragm. In this paper, we present our modified techniques of transperitoneal minimally invasive surgery for diaphragmatic eventration.

• Authors: Tomohide Hori, Koichi Masuda, Kentaro Taniguchi, Makoto Iwasaki, Hideko Kuzuhara, Shinya Okamoto, Shotaro Saegusa, Shintaro Yagi, Taku Iida, Shinji Uemoto
• Journal: Surgical laparoscopy, endoscopy & percutaneous techniques (Surg Laparosc Endosc Percutan Tech) Vol. 19 Issue 2 Pg. e46-50 (Apr 2009) ISSN: 1534-4908 [Electronic] United States
• PMID: 19390263 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Diaphragm (surgery)
• Diaphragmatic Eventration (surgery)
• Female
• Humans
• Laparoscopy (methods)
• Minimally Invasive Surgical Procedures
• Peritoneum (surgery)
• Surgical Stapling (instrumentation, methods)