2018 Volume 32 Issue 1 Pages 94-98
A 68-year-old woman was diagnosed with an elevation of the left diaphragm on a chest radiograph more than 20 years ago. She experienced exertional dyspnea for one year and was referred to our hospital. Chest radiograph and CT revealed an elevation of the left diaphragm, with deviation of the peritoneal organ to the cranial side and deviation of the heart to the right side. Restrictive ventilatory impairment, with a vital capacity (VC) of 1.58 L and %VC of 66.7%, was detected on a pulmonary function test. Diaphragmatic eventration was diagnosed as the cause of her symptom. Therefore, three-dimensional (3D) complete video-assisted thoracoscopic surgery (VATS) diaphragmatic plication was performed. Pushing the diaphragm to the abdominal side, eight U stitches with predget were placed from the anteroposterior to posterolateral diaphragm. Three months after the surgery, her dyspnea had disappeared and VC and %VC had improved to 2.30 L and 97.5%, respectively.
We suggest that diaphragmatic plication thorough a VATS approach may become a standard surgical method for diaphragmatic eventration. For an operative method of this type that requires a stereognostic sense, such as for a suture technique under monitoring, the adoption of a 3D thoracoscopic system might be useful.
