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Ann Thorac Surg 1999;68:2364-2365
© 1999 The Society of Thoracic Surgeons

How to Do It

Mini-thoracotomy for diaphragmatic plication with thoracoscopic assistance

David T.M. Lai, FRACSa, Hugh S. Paterson, FRACSa

a Department of Cardiothoracic Surgery, Westmead Hospital, Sydney, Australia

Address reprint requests to Dr Paterson, Department of Cardiothoracic Surgery, Westmead Hospital, Hawkesbury Rd, Westmead, NSW 2145, Australia

We describe a technique of mini-thoracotomy to plicate the paralyzed hemidiaphragm with thoracoscopic assistance. Most of the hemidiaphragm can be plicated expeditiously under direct vision with light derived from a posterior thoracoscope placed in the auscultatory triangle. Videoscopic vision is employed only occasionally when the view of the posteromedial hemidiaphragm is obscured. Continuous suture traction can be easily applied through the mini-thoracotomy, thus maintaining suture tension and enabling maximal inversion of the elevated hemidiaphragm.




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