Diaphragmatic eventration plication repair with minimal access techniques: a case series


  • Aditya C. Oak Digestive Disease Centre, Zen Hospital, Mumbai, Maharashtra, India
  • Vishakha R. Kalikar Digestive Disease Centre, Zen Hospital, Mumbai, Maharashtra, India
  • Ankur K. Patel Digestive Disease Centre, Zen Hospital, Mumbai, Maharashtra, India
  • Roy V. Patankar Digestive Disease Centre, Zen Hospital, Mumbai, Maharashtra, India




Diaphragm, Eventration, Plication, Laparoscopy, Thoracoscopy, Minimal access surgery


Diaphragmatic eventration is a rare pathological condition occurring in <0.05% individuals causing the diaphragm to permanently ascend into the chest due to partial or complete replacement of diaphragmatic musculature by fibroblastic tissue. Congenital diaphragmatic eventration rarely presents among adults with most patients remaining asymptomatic only to be diagnosed incidentally after chest radiography. Symptomatic patients can present with dyspnoea, orthopnoea, recurrent lower respiratory tract infections or gastrointestinal symptoms. Management varies according to symptoms with asymptomatic cases requiring no intervention and plication being the standard, well-described technique for symptomatic cases. Here we described two cases with eventration approached using different minimal access techniques.


Chin EF, Lynn RB. Surgery of eventration of the diaphragm. J Thorac Surg. 1956;32(1):6-14.

Sinha R, Dalal S, Sodhi K. A neonate with eventration of diaphragm. Open Acc Lib J. 2015;2(5):1547.

Petit JL: Traité des maladies chirurgicales et des opérations qui leur conviennent/Oeuvres posthumes de chirurgie, mises au jour par M Lesne [FDI. 3 vols. Paris: Prault. 1774;1:230.

Guzman JPS, Santos NCD, Baltazar EA, Baquir ATD. Congenital unilateral diaphragmatic eventration in an adult: a rare case presentation. Int J Surg Case Rep. 2017;35:63-7.

Shah SZA, Khan SA, Bilal A, Ahmad M, Muhammad G, Khan K, et al. Eventration of diaphragm in adults: eleven years’ experience. J Ayub Med Coll Abbottabad. 2014;26(4):459-62.

Visouli AN, Mpakas A, Zarogoulidis P, Machairiotis N, Stylianaki A, Katsikogiannis N, et al. Video assisted thoracoscopic plicationof the left hemidiaphragm in symptomatic eventration in adulthood, J Thorac Dis. 2012;4(1):6-16.

Srikrishna MR, Ravishankar NR, Raghavan J, Natarajan MK, Surgical repair of congenital diaphragmatic eventration in a septugerian lady, Braz J Cardiovasc Surg. 2010;25(1):115-7.

Mouroux J, Venissac N, Leo F, Alifano M, Guillot F. Surgical treatment of diaphragmatic eventration using video-assisted thoracic surgery: a prospective study. Ann Thorac Surg. 2005;79(1):308-12.

Gierada DS, Slone RM, Fleishman MJ. Imaging evaluation of the diaphragm. Chest Surg Clin North Am. 1998;8(2):237-80.

Groth SS, Andrade RS. Diaphragm plication for eventration or paralysis: a review of the literature. Ann Thorac Surg. 2010;89(6):2146-50.

Kizilcan F, Tanyel FC, Hicsonmez A, Buyukpamukcu N. The long-term results of diaphragmatic plication. J Pediatr Surg. 1993;28(1):42-4.

Huttl TP, Wichmann MW, Reichart B, Geiger TK, Schildberg FW, Meyer G. Laparoscopic diaphragmatic plication: long term results of a novel surgical technique for postoperative phrenic nerve palsy. Surg Endosc. 2004;18(3):547-51.






Case Series