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Case report
Minimally invasive repair of right-sided blunt traumatic diaphragmatic injury
  1. Keiko Shichiri,
  2. Kiyotaka Imamura,
  3. Minoru Takada and
  4. Yoshiyasu Anbo
  1. Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
  1. Correspondence to Dr Keiko Shichiri; shichiri.k.7{at}gmail.com

Abstract

Right-sided blunt traumatic diaphragmatic injury (TDI) is a rare injury that is rarely repaired by the minimally invasive approach in the acute setting. Laparoscopic repair of right-sided TDI is challenging because the liver often obstructs access to the injury site. Herein, we report a case wherein acute right-sided blunt TDI was successfully repaired using a combined laparoscopic and thoracoscopic approach. A 30-year-old man presented with shortness of breath after falling on his back while jumping on a snowboard. CT revealed a right-sided TDI. As the patient was haemodynamically stable, laparoscopic repair was planned. Laparoscopy revealed a right-sided diaphragmatic rupture. As the posterior portion was covered by the liver and difficult to access, we added trocars in the chest cavity and closed the diaphragmatic defect with a thoracic approach. A combined laparoscopic and thoracoscopic approach can repair right-sided diaphragmatic injury by a minimally invasive approach even in the acute setting.

  • surgery
  • general surgery
  • orthopaedic and trauma surgery

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Footnotes

  • Contributors KS contributed to conceptualisation and design of the study, drafting the manuscript, participation in the treatment and perioperative management of the patient, approval of the final manuscript. KI contributed to conceptualisation and design of the study, participation in the treatment and perioperative management of the patient, approval of the final manuscript. MT contributed to the participation in the treatment and perioperative management of the patient, approval of the final manuscript. YA involved in the approval of the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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