VATS Diaphragm Plication

This video demonstrates a VATS diaphragm plication. The patient had phrenic nerve paralysis of the left hemidiaphragm from an unknown cause. The patient had to give up his job due to shortness of breath and had a restrictive defect that was 30% worse in supine lung function testing. Ventilation scanning also demonstrated only 20% left lung ventilation. He was accepted for VATS plication. The operation was performed using two 5mm ports and a 10mm port using CO2 unsufflation. An endostitch device was used to progressively plicate the diaphragm and pledgets were added to each suture. The operating time was 120 minutes and the patient was discharged on the fourth postoperative day.