Surgical Approaches to the Diaphragm
Key Points
- Surgery involving the diaphragm can be required for a number of diaphragmatic and nondiaphragmatic abnormalities.
- It entails thoracic, abdominal, and combined thoracoabdominal approaches.
- Minimally invasive video-assisted thoracoscopic and laparoscopic approaches with or without robotic assistance are increasingly being employed.
- The diaphragm can be widely incised with no functional compromise, provided that major branches of the phrenic nerves are respected.
- Most of transdiaphragmatic surgical procedures can be optimally performed through a circumferential peripheral phrenotomy.
The diaphragm is a musculotendinous structure that provides an anatomic barrier separating the pleural cavities and pericardium from the abdomen. A competent surgeon needs to be confident using all of the available surgical modalities, which, aside from the classic thoracic, abdominal, and combined thoracoabdominal open approaches, include minimally invasive thoracoscopic and laparoscopic approaches with or without robotic assistance.
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Last updated: March 15, 2023
Citation
Pompeo, Eugenio, and Federico Tacconi. "Surgical Approaches to the Diaphragm." Pearson's General Thoracic Surgery. STS Cardiothoracic Surgery E-Book, Chicago: Society of Thoracic Surgeons, 2023. STS Surgery, ebook.sts.org.
Pompeo E, Tacconi F. Surgical Approaches to the Diaphragm. In: Darling GE, Baumgartner WA, Jacobs JP, eds. Pearson's General Thoracic Surgery. STS Cardiothoracic Surgery E-Book. Chicago: Society of Thoracic Surgeons; 2023. ebook.sts.org. Accessed September 30, 2023.
Pompeo, E., & Tacconi, F. (2023). Surgical Approaches to the Diaphragm. In Darling, G., Baumgartner, W., & Jacobs, J. (Eds.), Pearson's General Thoracic Surgery. STS Cardiothoracic Surgery E-Book. Chicago: Society of Thoracic Surgeons. ebook.sts.org
Pompeo E, Tacconi F. Surgical Approaches to the Diaphragm [Internet]. In: Darling GE, Baumgartner WA, Jacobs JP, editors. Pearson's General Thoracic Surgery. STS Cardiothoracic Surgery E-Book. Chicago: Society of Thoracic Surgeons; 2023. [cited 2023 September 30]. Available from: ebook.sts.org.
* Article titles in AMA citation format should be in sentence-case
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T1 - Surgical Approaches to the Diaphragm
ID - 1418495
ED - Jacobs,J,
ED - Darling,Gail,
ED - Baumgartner,William,
Y1 - 2023/03/15/
BT - Pearson's General Thoracic
UR - https://ebook.sts.org/sts/view/Pearsons-General-Thoracic/1418495/all/Surgical_Approaches_to_the_Diaphragm
PB - Chicago: Society of Thoracic Surgeons
DB - STS Surgery
DP - Unbound Medicine
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