Laparoscopic robotic diaphragmatic plication

Laparoscopic and robotic-assisted laparoscopic diaphragm plication is a safe, effective, and minimally invasive surgical alternative to transthoracic approaches. Theoretic advantages of the laparoscopic approach are operative space and potentially less pain, but access to the posterior diaphragm in obese patients is more challenging than via a transthoracic approach. Midterm results with standardized quality of life questionnaires and imaging have shown excellent symptomatic improvement and radiologic confirmation of a persistent diaphragm position. In summary, robotic-assisted laparoscopic diaphragm plication is a good therapeutic alternative to transthoracic approaches.