Diaphragm Plication

Diaphragm Plication

Diaphragm plication is a surgical procedure to tighten the paralyzed diaphragm to improve overall function of the lung. It is used to treat diaphragm paralysis or eventration of the diaphragm.

Operation

We use the most advanced robotic system called Da Vinci Xi to perform diaphragm plication. The name of the procedure is “Robot-assisted diaphragm plication.” We perform the procedure through small incisions in the chest. We then place sutures with pledgets to tighten the paralyzed or laxed diaphragm. A chest tube is placed in the area at the end of surgery to remove any fluid.

Overall, the risks of the operation are very low. With any operation, there is a risk of injuring any structure that we operate around including the lung, pericardium, liver, stomach, colon, and spleen. Other risks may include bleeding and infection at the site of surgery. There is always a risk of needing to convert from a small incision to a larger incision to safely complete the operation.

Hospital Stay: 1 Day

After the operation, the patient goes to a recovery area called PACU or post-anesthesia care unit. Once the patient recovers from anesthesia, he or she is admitted to the floor. On average, patients are in the hospital for one night. Patients start a regular diet during the night of the surgery along with pre-emptive pain control with around the clock pain medication. Every day, the chest tube will be evaluated to determine if the tube can be safely removed. Once the patient’s chest tube is removed with good pain control, they are ready to continue the recovery at home.

Pain Management

We advise our patients to stay ahead of the pain with pre-emptive pain control. Instead of taking pain medication after having pain, we ask patients to take pain medication in regular intervals. The typical regimen for post-operative pain medication is:

3 days of Aleve (Naprosyn) 1 tab two times a day

5 days of Tylenol (Acetaminophen) 1 g three times a day

7 days of Neurontin (Gabapentin) 300 mg three times a day.

After 7 days, take Tylenol as needed. If this regimen is not adequate to control pain, we ask patients to call our office.

Activity

In order to further help with recovery from surgery, we advise patients to walk at least three times a day, work on the incentive spirometer, and sit in a chair for at least 6 hours a day for about a week after the surgery. We advise patients to avoid heavy lifting for 6 weeks. As long as the patient is not on narcotic pain medication, it is safe to drive.