VATS Diaphragm Repair (Video-Assisted Thoracoscopic Diaphragmatic Repair)

Procedure Description and Technique

VATS diaphragm repair is a minimally invasive surgical procedure performed to correct diaphragmatic hernias or tears in the diaphragm muscle, which separates the chest cavity from the abdominal cavity and plays a crucial role in respiration. Using video-assisted thoracoscopic surgery, the surgeon accesses the diaphragm through small incisions in the chest wall, identifies the defect, and repairs it using sutures or a reinforcing mesh depending on the size and severity.

Common Indications for Surgery

This surgery is indicated for congenital or acquired diaphragmatic hernias, as well as traumatic diaphragm tears caused by accidents or complications from prior surgeries. It is also used in some cases of diaphragmatic paralysis that lead to breathing difficulty or abnormal diaphragm elevation. If left untreated, these conditions can result in impaired lung ventilation and pressure on abdominal or thoracic organs.

Repair Mechanism and Surgical Safety

Once the defect is located, the surgeon isolates it and either directly sutures the muscle edges or reinforces the area with a synthetic mesh in cases of large or weakened defects. The VATS approach offers enhanced visualization of the defect and surrounding tissues, reducing the risk of complications. Compared to open surgery, it causes less pain, shorter hospitalization, and quicker recovery while preserving pulmonary function.

Postoperative Care and Recovery

A chest drain is typically placed after surgery to evacuate air or fluids. The patient is monitored with imaging to confirm proper lung expansion and diaphragm motion. Respiratory support and gradual breathing exercises are initiated as needed. Most patients recover within a few weeks and experience significant improvement in breathing function and resolution of related symptoms.