Laparoscopic Surgery for Left Diaphragmatic Eventration

Dr John AC Thanakumar Senior Surgeon, Minimal Access, Bariatric and GI Surgery, Global Hospital, Chennai www.lapsurge.org Video shows left diaphragmatic eventration on chest xray and CT scan. Laparoscopic method of reduction of contents of stomach, small bowel, splenic flexure and omentum after Nathanson liver retraction is demonstrated. The eventration of diaphragm is demonstrated. The edges for costal attachment of the diaphragm are marked for attachment of the compound mesh. Proceed mesh is used with the visceral side on the abdominal contents. Pleura in course of time will get attached to the mesh. Mesh is secured with both tackers ( on the peripheral areas like costal attachments and sutures ( on the medial edges like pericardial areas). After satisfactory attachment of the mesh with nearly attachments every 1 cm, the loose tack is removed. CO2 is evacuated and abdomen is closed without any drainage.