What Is Diaphragm Plication Surgery?

Diaphragm plication is a procedure to treat a paralyzed diaphragm. The diaphragm is a thin, dome-shaped muscle that separates your chest and abdomen. When you inhale, your diaphragm will move down to create more space in your chest. When you have a paralyzed diaphragm, your diaphragm moves upward when you inhale instead, taking up the space in your chest where your lungs should expand.

During plication, we tighten the diaphragm so it stays in its contracted position. This allows for enough space in your chest to inhale properly.

Candidate Criteria for Diaphragm Plication

Not everyone needs surgery for a paralyzed diaphragm. You may be a candidate for diaphragm plication if you have:

During the Procedure

Our cardiothoracic surgeons use minimally invasive robotic surgery to perform diaphragm plication. You will receive anesthesia to remain asleep during the procedure. Then, your surgeon will:

  1. make three 1-centimeter incisions (cuts) in between your ribs on the side of the paralyzed diaphragm,
  2. insert small tools through the incisions, and
  3. use a robotic surgical device that enhances visualization and maneuverability to fold the diaphragm on top of itself and sew it into place.

Diaphragm Plication Surgery Time

A robotic diaphragm plication lasts around one hour.

How to Prepare

You will have a full work-up with our cardiothoracic surgeons before a diaphragm plication. Your providers will run multiple tests to view your diaphragm and diagnose a paralyzed diaphragm.

Then, you will have a preoperative assessment where you will meet with our anesthesia team, get blood drawn, and have a physical. This assessment ensures you’re healthy enough for surgery and know what to expect.

Diaphragm Plication Surgery Recovery

You will stay in the hospital for up to two nights after diaphragm plication. You’ll be up and walking as usual when you return home. Our anesthesiologists will give you options to manage your pain in the hospital and during recovery.

Diaphragm Plication Recovery Time

Most people are back to work and other usual routines within two weeks. It may take up to six weeks to get back to your usual energy levels.

Diaphragm Plication Side Effects

You may feel some soreness for about two weeks after surgery, but the pain usually doesn’t impact your daily activities. Some people have nerve pain that lasts around six months.

Like other surgeries, diaphragm plication may cause complications, including bleeding or infection. However, most patients don’t experience complications.

Diaphragm Plication Success Rate

Diaphragm plication is a highly effective treatment, with our success rates at University of Utah Health close to 100 percent. If you have shortness of breath caused by a paralyzed diaphragm and no other underlying conditions, you’ll likely find relief with diaphragm plication surgery.

Our Cardiothoracic Surgeons

Why Choose U of U Health?

Our thoracic surgery team accepts referrals from all over the country, meaning we regularly treat patients with complex needs. We routinely perform diaphragm plications, which aren't commonly performed at all centers nationwide.

We are the only surgeons in the Mountain West region who perform robotic diaphragm plications. Our thoracic surgeons are all credentialed in robotic surgery technology and are national experts in these techniques. We are a multidisciplinary team that includes the expertise of cardiothoracic surgeons, pulmonologists, general surgeons, neurosurgeons, neurologists, and sleep specialists.

How to Schedule an Evaluation with Our Cardiothoracic Specialists

To make an appointment with our cardiothoracic team, call 801-585-6740. We encourage you to get a referral from your primary care provider, but we do accept self-referrals. Our team will help you verify your insurance coverage. Most insurance plans will cover diaphragm plication as a treatment for a paralyzed diaphragm.

To refer a patient for cardiothoracic surgery, complete our referral form or call 801-585-6740.