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FlexDex™ Needle Holder Used to Perform a Diaphragm Plication

Wednesday, June 13, 2018

Dunning J. FlexDex™ Needle Holder Used to Perform a Diaphragm Plication. June 2018. doi:10.25373/ctsnet.6450296.

This is a video demonstrating the use of the FlexDex™ needle holder to perform a left video-assisted thoracoscopic (VATS) diaphragm plication (1). The FlexDex™ needle holder is a new device that allows the wristed flexibility of robotic surgery with the by-the-bedside "surgeon-powered" convenience of VATS. The author uses it for the first time in the UK for a diaphragm plication, where a line of horizontal mattress sutures was needed to plicate the diaphragm in a patient with idiopathic phrenic nerve paralysis.


  1. Celik S, Celik M, Aydemir B, Tunckaya C, Okay T, Dogusoy I. Long-term results of diaphragmatic plication in adults with unilateral diaphragm paralysis. J Cardiothorac Surg. 2010;5:111.


Joel: Great instrument and technique. Myself (and others ) have used the Endo-Stitch successfully but the knot tying is the bottleneck. So, on my last case, I used the Cor-Knot. Wow. It is fast and easy. Fits through a 5 mm port. To use the Cor-Knot, I just pulled the suture out of the port using a grasper and then slid the Cor-Knot down through the same port. It cuts, so no scissors (instrument exchange) needed !

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