Robot-Assisted Laparoscopic Diaphragm Plication

Though their etiology and pathology are distinct, the treatment of symptomatic diaphragm eventration and paralysis is the same – diaphragm plication. Though there is little data to objectively compare plication techniques, all offer significant improvement in symptoms, pulmonary function, and respiratory quality-of-life scores. Nonetheless, potential advantages of a robot assisted laparoscopic approach to plication include lower morbidity than thoracotomy and laparotomy techniques; avoidance of single lung ventilation, less intercostal nerve pain, and greater working domain compared with thoracotomy and thoracoscopic approaches; and enhanced dexterity as compared with standard laparoscopic instrumentation.