CHAPTER 32 Diaphragmatic Plication—Video 32 Robert J. McKenna, Jr. Introduction Plication of a paralyzed diaphragm can relieve dyspnea and substantially improve pulmonary function. The procedure is underused and may be performed well as video-assisted thoracic surgery (VATS). The diaphragm absorbs the pleural fluid created daily in the pleural space, and when the diaphragm is plicated well, there is much less absorptive surface. Patients may drain a surprisingly large amount of fluid postoperatively through the chest tube, and the hospital stay may be 1 week. Approach to Video-Assisted Diaphragmatic Plication Order of Operative Steps The order of the steps of the operation is as follows: caudal pressure on the diaphragm and repeated suturing of the diaphragm obliquely from anterior to posterior (Video 32-1). Key Points ♦ The chronically paralyzed diaphragm is displaced very superiorly. ♦ Good exposure is the key to starting the procedure. The incision in the auscultatory triangle produces downward pressure on the diaphragm to provide exposure for the procedure. ♦ The plication is performed anteromedially to posterolaterally, with running sutures placed back and forth. ♦ Make the incisions low enough so the diaphragm may be plicated tightly. Video-Assisted Diaphragmatic Plication Step 1. Incisions ♦ Exposure: Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: Thoracoscopic Sympathectomy Right Upper Lobe Anterior Segmentectomy—Video 19 Left Upper Lobe Apical Trisegmentectomy—Video 16-1 Pneumonectomy—Video 7 Stay updated, free articles. Join our Telegram channel Join Tags: Atlas of Minimally Invasive Thoracic Surgery Jun 4, 2016 | Posted by admin in CARDIAC SURGERY | Comments Off on Diaphragmatic Plication—Video 32 Full access? Get Clinical Tree
CHAPTER 32 Diaphragmatic Plication—Video 32 Robert J. McKenna, Jr. Introduction Plication of a paralyzed diaphragm can relieve dyspnea and substantially improve pulmonary function. The procedure is underused and may be performed well as video-assisted thoracic surgery (VATS). The diaphragm absorbs the pleural fluid created daily in the pleural space, and when the diaphragm is plicated well, there is much less absorptive surface. Patients may drain a surprisingly large amount of fluid postoperatively through the chest tube, and the hospital stay may be 1 week. Approach to Video-Assisted Diaphragmatic Plication Order of Operative Steps The order of the steps of the operation is as follows: caudal pressure on the diaphragm and repeated suturing of the diaphragm obliquely from anterior to posterior (Video 32-1). Key Points ♦ The chronically paralyzed diaphragm is displaced very superiorly. ♦ Good exposure is the key to starting the procedure. The incision in the auscultatory triangle produces downward pressure on the diaphragm to provide exposure for the procedure. ♦ The plication is performed anteromedially to posterolaterally, with running sutures placed back and forth. ♦ Make the incisions low enough so the diaphragm may be plicated tightly. Video-Assisted Diaphragmatic Plication Step 1. Incisions ♦ Exposure: Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: Thoracoscopic Sympathectomy Right Upper Lobe Anterior Segmentectomy—Video 19 Left Upper Lobe Apical Trisegmentectomy—Video 16-1 Pneumonectomy—Video 7 Stay updated, free articles. Join our Telegram channel Join Tags: Atlas of Minimally Invasive Thoracic Surgery Jun 4, 2016 | Posted by admin in CARDIAC SURGERY | Comments Off on Diaphragmatic Plication—Video 32 Full access? Get Clinical Tree
Video-Assisted Diaphragmatic Plication
