Redo Diaphragm Plication With Cryoanalgesia

Phrenic nerve paralysis is not an uncommon problem (1), and it can cause diaphragm paralysis.

This gentleman had a thoracotomy and diaphragm plication four years previously. Unfortunately, the plication failed, and he had quite significant pain and remained short of breath.

Thus, the author accepted him for redo diaphragm plication. Due to the high risk of further pain, the author offered to perform cryoanalgesia to the intercostal nerves that had caused his pain on the previous occasion. 

This video demonstrates the redo procedure and the techniques used to plicate the diaphragm again. It also shows how the author performed the cryoanalgesia with the AtriCure probe.

References

1. Groth SS, Andrade RS. Diaphragm plication for eventration or paralysis: a review of the literature. Ann Thorac Surg. 2010;89(6):S2146-S2150.