Definition and Overview

Before a person undergoes diaphragm surgery, he is scheduled for a consultation with a surgeon so he can find out how such a procedure can benefit him.

Surgical procedures can be performed as part of the treatment for conditions and trauma-related injuries that affect the diaphragm, which is a large, dome-shaped muscle positioned right below the lungs and in between the chest and abdomen. Also known as thoracic diaphragm because it is part of the thoracic cavity, it is a very important component of the respiratory system. Divided into two parts, namely the peripheral muscular and central aponeurotic parts, it contracts and expands every time a person inhales and exhales. As such, it is recognised as the primary muscle responsible for aspiration or inhalation.

Just like other parts of the body, the diaphragm can also be affected by disorders and injuries, some of which can be treated with surgery. In such cases, a pre-surgical consultation with a surgeon is in order.

Who Should Undergo and Expected Results

A diaphragm surgery consultation is the first step towards seeking treatment for disorders and injuries affecting the diaphragm. The list of diaphragmatic diseases and disorders is not long, but the diaphragm is sometimes affected by other underlying diseases, such as:

  • Stroke
  • Muscular dystrophy
  • Multiple sclerosis
  • Thyroid disorder Lupus
    Other than these, a person may also suffer from congenital birth defects, developmental abnormalities, trauma, or blunt force injuries that can damage the diaphragm. The body part can also be affected by other risks to health, such as infection, exposure to radiation and malnutrition, among others.

A person with a problem with his diaphragm may experience the following symptoms:

  • Trouble breathing
  • Pain when breathing
  • Making fewer breathing sounds than normal
  • Chest pain
  • Shoulder pain
  • Abdominal pain
  • Hypoxemia, or when there is not enough oxygen in the blood
    Diaphragm disorders, diseases and injuries are usually treated with medication. However, there are some instances wherein the patient does not seem to respond to the drugs or is suffering from severe side effects. This makes surgery a more likely and effective treatment option. Candidates for this type of surgery are scheduled for a consultation to provide them with adequate information about the procedure so they can decide whether or not they will go ahead with it.

How the Procedure Works

A diaphragm surgery consultation takes place at the surgeon’s clinic or office and may last for at least an hour, depending on whether some tests are necessary. During the consultation, the surgeon will review the patient’s medical history and assess his complaints and symptoms. In some cases, the consultation is performed upon the referral of a physician, so test results and diagnostic information are likely to be already available. Thus, the surgeon may only need to listen to the patient’s heartbeat and breathing to provide an accurate recommendation on the most appropriate treatment method.

If this is not the case or if the surgeon needs more information, a number of tests will be performed during the consultation or at a later time. Tests that can help diagnose a problem with the diaphragm include:

  • Chest x-ray
  • Fluoroscopy
  • Transdiaphragmatic pressure measurement
  • Nerve conduction study
  • Pulmonary function test
  • Arterial blood gas testing
    At the end of a diaphragm surgery consultation, the surgeon will inform the patient whether or not surgery is his best option, what he can expect from undergoing the procedure and what kind of surgical technique will be performed. The risks and limitations of surgery will also be discussed.

Possible Risks and Complications

A person suffering from symptoms of a diaphragm problem should consult a specialist, especially if the symptoms are severe, the condition is serious, or medications are not helping. Seeking this type of consultation helps a person explore all his available treatment options that can prevent the development of serious risks to his health. In severe cases, problems with the diaphragm may cause paralysis, although this is quite rare.

Diaphragm surgery is a major surgical procedure that may involve folding the muscle, repairing any physical damage, or removing a part of it or some abnormal tissue. This surgery is not without risks, so doctors can employ modern techniques, such as using smaller incisions to keep risks under control and promote faster recovery.

References:

  • Keller RL, Guevara-Gallard S, Farmer DL. Surgical disorders of the chest and airways In: Gleason CA, Devaskar SU, eds. Avery's diseases of the newborn. 9th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 49.

  • Tsao KJ, Lally KP. Congenital diaphragmatic hernia and eventration In: Holcomb GW, Murphy JP, Ostlie DJ, eds. Ashcraft's Pediatric Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 24.

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