Diaphragm paralysis can cause significant shortness of breath. This condition can be treated with diaphragm plication. We illustrate two cases where we used a knotless suture and total portal thoracoscopic technique to successfully plicate the diaphragm. A 70-year-old female with right-sided and a 44-year-old male with left-sided diaphragm paralysis. Both patients had a sniff test that showed paradoxical movement of the diaphragm. The port placements during the procedure were different due to the laterality but both patients had three 5-mm ports and one 12-mm port for the procedure. Plication was performed using the Endo Stitch knotless suture. Both patients went home on post-operative Day 1 without any complications. After 1 month, both patients had significant improvement in shortness of breath with resolution of the diaphragm elevation.
- Journal Article