The diaphragm is a thin sheet of muscle that separates the chest from the abdomen. Physiologically, it contracts to help with breathing as a major muscle of inspiration. When dysfunctional, it can be abnormally elevated, and associated with lung collapse and shortness of breath. Common causes of diaphragmatic dysfunction include traumatic injury to the phrenic nerve, which controls the diaphragm, or the diaphragmatic muscle itself. Sometimes, the underlying cause is unclear, but the diaphragm is found to be elevated on imaging, particularly when lying flat. Patients can experience severe shortness of breath as a result of diaphragmatic dysfunction, especially when lying down or after strenuous exercise.

Surgery can significantly improve diaphragmatic dysfunction by flattening or ‘plicating’ the diaphragmatic muscle. Under direct vision, the excess tissue of the diaphragm is sutured and tied using a series of permanent sutures that keep the diaphragm flat. This will in most cases allow the underlying lung to re-expand and improve symptoms of shortness of breath. Associate Professor Christopher Cao specializes in minimally invasive robotic diaphragmatic plication procedures, and performs one of the highest numbers of this procedure in Australasia.

‘The surgery was such a success that the moment I woke up I felt like I could breathe again, and that was the best feeling in the world… I will be forever grateful to Dr Cao and his team for giving me this second chance to enjoy a full life.’ – Danielle Allan. Read her story