Laparoscopic Plication of Eventration of Left Hemidiaphragm: Capnothorax Overcomes Technical Difficulties

Dr. A.K. Mathur; Dr. Praveen K. Mathur

Volume : X, Issue : VI, June - 2020

Laparoscopic Plication of Eventration of Left Hemidiaphragm: Capnothorax Overcomes Technical Difficulties

Dr. A. K. Mathur, Dr. Praveen K. Mathur

Abstract :

Diaphragmatic eventration is a relatively rare condition with an incidence of 1 in 10,000 live births. It is defined as a permanent elevation of a hemi diaphragm without defects of continuity. Recurrent respiratory distress and chest infections are common presenting complaints5. 5 adult symptomatic patients of eventration of left hemidiaphragm were operated over a period of 7 years from 2010 to 2017 by a single surgeon. They presented with moderate to severe respiratory distress and recurrent pneumonia. Diagnosis of eventration suspected on clinical examination was confirmed on X–ray chest and CT scan. Later also revealed abdominal viscera migrating to left hemi thorax. Laparoscopic plication of left hemi– diaphragm was done. Capnothorax created in a case of severe eventration, greatly eased the technical difficulties in plication. Average hospital stay was 5 days. In two patients, dual mesh was added to strengthen the repair. After surgery, patients were given intensive respiratory exercises and all the patients showed complete recovery from dyspnea over a follow up period of 3 months. One patient, however, had partial recurrence after 6 months. He was explored and proper plication was done.