VATS Repair of Right Bockdalek Hernia and Diaphragmatic Plication

This video demonstrates a VATS repair of a symptomatic adult congenital right Bochdalek hernia and plication of the diaphragm. A 41-year-old female patient presented with worsening shortness of breath and the inability to lie flat. Her CT scan was suggestive of liver herniation through the right diaphragm, and there was no interstitial lung disease to explain the dyspnoea. Fluoroscopic screening of the chest revealed significant paradoxical movement of the diaphragm despite normal phrenic nerve conduction studies. This video explains the VATS approach and details of the repair to the hernia, as well as the steps of the plication. The patient reported remarkable improvement from the operation. She was able to lie flat again after a very long period of having to lie propped up at night. The author believes that the VATS approach is safe and feasible.

Disclosure: The author has received past honoraria from Ethicon against educational presentations.