The diaphragm lies between the chest cavity and abdominal cavity, and is a muscle that helps the lungs inhale to the largest possible volume by moving downwards during each inhalation. The diaphragm is the most important respiratory muscle and a reduction of its function severely limits respiratory capacity. Surgical interventions on the diaphragm are required when a widening of the natural openings in the diaphragm occurs, in particular where the oesophagus passes through it. These expansions can lead, for example, to acid reflux, where the stomach contents repeatedly come up into the oesophagus. Very marked changes in the diaphragm can even lead to the whole stomach riding up into the chest cavity.
Surgery for diaphragmatic hernia
Diaphragmatic hernia surgery is usually necessary either in the case of severe reflux disease, or if all or part of the stomach has ridden up into the chest. The surgery involves essentially correcting the position of the stomach, or rather the transition point of the esophagus and stomach, and reducing the gap in the diaphragm, so that the oesophagus is exactly accommodated. Often this operation on the diaphragm is combined with anti-reflux surgery on the stomach. These procedures are normally carried out laporoscopically or thoroscopically, and the hospital stay is usually less than a week.
Surgery for diaphragmatic paralysis
In rare cases where respiratory capacity is limited by bilateral diaphragmatic paralysis, it may be necessary to stretch the diaphragm back down. In this situation, a gathering can be made in the middle of the diaphragm with a special instrument, so that the entire diaphragm can be pushed further down into the abdominal cavity, thus increasing the lung capacity. This procedure can be carried out thoroscopically, and requires only a few days’ hospitalisation.