Robotic‐assisted diaphragmatic plication: Improving safety and effectiveness in the treatment of diaphragmatic paralysis

Lampridis, Savvas; Pradeep, I. H. D. S.; Billè, Andrea

doi:10.1002/rcs.2368

Cited by 12 publications

(10 citation statements)

References 31 publications

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“…Since then, surgical plication has been established as a valid option for the treatment of symptoms associated with unilateral diaphragmatic paralysis (11,12). Minimally invasive diaphragmatic plication has also been shown to be a safe and effective strategy for the management of diaphragmatic paralysis (13) (14). Both of our patients showed subjective improvement of their breathing and quality of life, with an additional improvement of FEV1 and DLCO.…”

Section: Discussionmentioning

confidence: 63%

Diaphragmatic paralysis post COVID-19 treated with robot-assisted plication reinforced with acellular dermal matrix: a report of two cases

Hurley

Djouani

Lampridis

et al. 2022

Monaldi Arch Chest Dis

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Coronavirus disease 2019 (COVID-19) continues to be a disease of global importance, with an increasing array of sequelae attributed to infection by the severe acute respiratory syndrome coronavirus-2. One such complication that has been rarely documented thus far is diaphragmatic dysfunction. Here, we report the cases of 2 individuals who developed diaphragmatic paralysis post COVID-19, which failed to respond to conservative management. Both patients proceeded to undergo robot-assisted thoracoscopic plication of the diaphragm reinforced with a bovine acellular dermal matrix. In both cases, there was significant improvement in symptomatology, namely dyspnoea and fatigue. We conclude that robot-assisted diaphragmatic plication should be considered for the treatment of refractory diaphragmatic paralysis post COVID-19.

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Section: Discussionmentioning

confidence: 63%

Diaphragmatic paralysis post COVID-19 treated with robot-assisted plication reinforced with acellular dermal matrix: a report of two cases

Hurley

Djouani

Lampridis

et al. 2022

Monaldi Arch Chest Dis

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“…As Lampridis et al [14], they report a shorter operative time due to greater ease during suturing, and an even better recovery. In our study, perioperative complications differed between RATS and VATS patients.…”

Section: Discussionmentioning

confidence: 81%

“…Studying children specifically, Slater et al [12] in 2008 and Xu et al [13] in 2020 have shown on two and nine patients, respectively, that robot-assisted diaphragmatic plication was feasible; just as in our five cases, they reported the same results pertaining to the efficacy of video-assisted surgery and without any additional complications. As Lampridis et al [14], they report a shorter operative time due to greater ease during suturing, and an even better recovery. In our study, perioperative complications differed between RATS and VATS patients.…”

Section: Discussionmentioning

confidence: 85%

Retrospective cohort analysis of surgical management for congenital diaphragmatic eventration in children

Alzahrani,

Heng,

Khen-Dunlop

et al. 2024

Preprint

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Background: Diaphragmatic plication is the most widely used surgical approach for treating congenital diaphragmatic eventration (CDE) in children. This study aims to assess current surgical practice for this pathology in children. Methods: Retrospective data analysis of a multicentric cohort of pediatric patients operated on for CDE between 2010 and 2021. Comparative description of the different surgical approaches and their outcomes, including robot-assisted thoracoscopic surgery (RATS). (Clinical TrialsNCT04862494). Results: 112 patients, aged 12 [5 - 21] months, were operated on for CDE. Diaphragmatic plication was performed using thoracoscopy or RATS in 69 (62%) cases, postero-lateral thoracotomy (PLT) in 15 (13%), and using an abdominal approach in 28 (25%). Relief of symptoms and improvement in the diaphragmatic level on chest radiographs were obtained in 88% and 90% of the cases, respectively. We recorded 32 peri- or early postoperative complications (29%) and eight recurrences of eventration (7%), but found no correlation between these complications and the surgical approach used. Compared to other approaches, PLT multiplied the duration of intravenous analgesia by three (96 vs 36h, p<0.0001), and the length of hospital stay by two (8 vs 4d, p = 0.002). Compared to thoracoscopy, RATS provided more perioperative hepatic injuries and equivalent short-term results, but all five patients remained symptomatic and two of them experienced chest wall deformities in long-term follow-up. Conclusions: Diaphragmatic plication via a minimally invasive thoracic approach may be the best treatment option for cases of symptomatic CDE. RATS emerges as a promising surgical approach, but further is required to confirm that it is, at least, not inferior to thoracoscopy.

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“…The comparison of the preoperative and postoperative PFTs demonstrated significant improvement in FEV 1 % of 19.9 ± 22.0 ( P < 0.05) and the mean increase in FEV 1 /FVC of 5.7% ± 2.5% ( P = 0.225) without a significant difference between groups (FEV 1 % improvement, 22.1% ± 23.8% vs 10.9% ± 17.5%, for the laparoscopic and thoracoscopic approach, respectively, P = 0.3661). Another retrospective single-center study comparing the robot-assisted thoracoscopic ( n = 11) and open transthoracic ( n = 9) approach was published recently by Lampridis et al 39 There were no conversions from robot-assisted to open approach. Two patients (10%) after robot-assisted surgery were represented with partial recurrence of diaphragmatic elevation and underwent further surgery with the open approach and diaphragmatic plication reinforcement with mesh.…”

Section: Resultsmentioning

confidence: 99%

Minimally Invasive Diaphragm Plication for Acquired Unilateral Diaphragm Paralysis: A Systematic Review

Gritsiuta

Gordon

Bakhos

et al. 2022

Innovations�(Phila)

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Objective: Diaphragm paralysis is a relatively uncommon entity that can be both congenital and acquired in nature. While commonly asymptomatic, it can also cause a significant decrease in pulmonary function and reserve, particularly in patients with underlying pulmonary diseases. Our aim was to summarize the current literature regarding the minimally invasive techniques used in the surgical correction of acquired diaphragm paralysis via traditional and robotic minimally invasive approaches. Methods: We conducted a systematic review of available literature using the Cochrane methodology and reported findings according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Results: A total of 6,561 citations were identified through initial database and reference searches, of which 90 articles met the inclusion criteria for review. After further assessment, 33 appropriate full-text studies were selected for the review. Of the selected publications, the majority represented case reports and single-center retrospective studies with level of evidence 4. Only 1 level 2b study (individual cohort study) was identified, comparing minimally invasive and open approaches. Conclusions: Each of the minimally invasive approaches has its unique benefits and disadvantages, which are summarized and delineated in this article. Ultimately, no preferred method of diaphragm plication for diaphragm paralysis can be recommended at this time based on clinical data. The choice of procedure and surgical approach continues to be selected based on the surgeon's experience and preference.

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Robotic‐assisted diaphragmatic plication: Improving safety and effectiveness in the treatment of diaphragmatic paralysis

Cited by 12 publications

References 31 publications

Diaphragmatic paralysis post COVID-19 treated with robot-assisted plication reinforced with acellular dermal matrix: a report of two cases

Diaphragmatic paralysis post COVID-19 treated with robot-assisted plication reinforced with acellular dermal matrix: a report of two cases

Retrospective cohort analysis of surgical management for congenital diaphragmatic eventration in children

Minimally Invasive Diaphragm Plication for Acquired Unilateral Diaphragm Paralysis: A Systematic Review

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