Diaphragmatic Eventration is a congenital (present at birth) condition that is characterized by the abnormal placement of diaphragm at a much higher level than normal. This could be because of paralysis of the diaphragm that results in its failure to contract. Very rarely it may affect adults or cause symptoms in adults.
Symptoms of Diaphragmatic Eventration
This condition often remains asymptomatic while some patients may experience following respiratory symptoms:
Chest pain particularly on exertion
Recurrent pneumonia, bronchitis, or cardiac arrhythmias
Diagnosis of Diaphragmatic Eventration
It is often diagnosed in a chest x-ray that is performed for assessment of some other problem. Its confirmation is done by performing a fluoroscopic examination and a CT scan. In addition to these, the function of the lungs is assessed by performing pulmonary function tests.
Laparoscopic surgery for Diaphragmatic Eventration
Laparoscopic Diaphragmatic Plication is performed for Diaphragmatic Eventration.
The procedure is performed under general anaesthesia with surgeon making 3-4 tiny incisions in the abdomen. One of the incisions is used to insert a port (nozzle) that fills the carbon dioxide gas into the abdomen to inflate it. Now laparoscope is inserted through another incision. A laparoscope is a telescope lookalike with a light and camera on the end. It allows the surgeon to clearly view inside of the abdomen on the monitor outside. After thorough exploration, folds are created and sutured in the diaphragm to reduce its mobility. This gives relief to the patient by improving lung function, exercise endurance, and dyspnea. After the completion of procedure, incisions are closed with sutures or staples, or covered with glue-like bandage.
Advantages of Laparoscopic Diaphragmatic Plication
Shorter operative time
Better cosmetic result
Shorter hospital stay
Shorter time to full feeds
Lower requirement for intravenous narcotics
Sooner return to work
Negligible risks and complications
Less chances of wound infection
High success rate
Improved respiratory symptoms