RT Book, Section
A1 Raad, Wissam
A1 Wolf, Andrea S.
A2 Sugarbaker, David J.
A2 Bueno, Raphael
A2 Burt, Bryan M.
A2 Groth, Shawn S.
A2 Loor, Gabriel
A2 Wolf, Andrea S.
A2 Williams, Marcia
A2 Adams, Ann
SR Print(0)
ID 1170416896
T1 Robotic Diaphragm Plication
T2 Sugarbaker’s Adult Chest Surgery, 3e
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781260026931
LK accesssurgery.mhmedical.com/content.aspx?aid=1170416896
RD 2024/09/13
AB Diaphragmatic  plication  is  commonly  performed  in  symptomatic  patients  with  diaphragmatic  eventration  or  phrenic  nerve  paralysis.  The  history  of  this  procedure  dates  back  to  1923  when  Morrison  described  the  first  plication  on  a  10-year-old  girl  who  reported  immediate  postoperative  relief.1  The  rationale  behind  plicating  the  lax  diaphragm  is  that  tightening  the  muscle  makes  it  easier  for  the  contralateral  diaphragm  to  be  more  effective.  Access  through  a  thoracotomy  is  the  gold  standard.  However,  with  the  introduction  of  minimal-access  surgery  and  robotic  assistance,  it  is  now  possible  to  apply  the  basic  tenets  of  open  surgery  principles  utilizing  smaller  incisions.  Multiple  studies  assessing  minimal-access  surgery  in  thoracic  surgical  procedures,  including  thoracoscopy  and  robotic  assistance,  have  demonstrated  shorter  length  of  stay,  decreased  postoperative  pain,  and  lower  requirements  for  narcotics.2–4  Therefore,  we  advocate  utilizing  robotic  assistance  for  diaphragmatic  plication  when  clinically  indicated.