Laparoscopic Diaphragmatic Plication in Patients with Unilateral Diaphragm Paralysis with Thoracoscopic Verification

Diaphragm eventration or paralysis causes elevation of the ipsilateral diaphragm. Some patients have symptoms. The most common symptom is dyspnea. In symptomatic patients with unilateral diaphragm paralysis and dyspnea disproportionate to the degree of physical activity, diaphragm plication is the treatment of choice to relieve dyspnea. We report on our experience with laparoscopic plication of a paralysed hemidiaphragm. The laparoscopic approach is an attractive surgical alternative for the treatment of phrenic nerve palsy. This technique combines the advantage of an excellent field of vision during surgery with a fast postoperative recovery and early discharge from hospital. In accordance to recent literature, we have successfully applied the laparoscopic approach to treat our patients who suffered from a unilateral paralysis of the diaphragm. Preoperative symptoms of exertional dyspnea and orthopnea were significantly reduced.