{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:41:33Z","timestamp":1792806093168,"version":"4.5.0"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T00:00:00Z","timestamp":1678665600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T00:00:00Z","timestamp":1678665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Freiburg"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Diaphragm plication remains the only effective treatment for diaphragm paralysis. Robot-assisted thoracoscopic (RATS) diaphragm plication combines advantages of open and thoracoscopic techniques. We present our experiences focussing on lung-function improvement and surgical outcome.\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>In this single-center retrospective study with comparative analysis, perioperative data of all patients who underwent RATS or thoracoscopic (VATS) diaphragm plication between 2015 and 2022 at our institution were assessed. Functional outcome was analysed with pre- and postoperative pulmonary function tests in sitting and supine position.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We included 43 diaphragm plications, of which 31 were performed via RATS. Morbidity in the RATS- and VATS-cohort were 13 and 8%, respectively (<jats:italic>p<\/jats:italic>\u2009=\u20090.64), without any major complication (Clavien-Dindo\u2009\u2265\u2009III, 0%). Surgical time for RATS diaphragm plication was reduced drastically with a median operating time for the first 16 patients of 136\u00a0min (range 84\u2013185) and 84\u00a0min (range 56\u2013122) for the most recent 15 patients (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). Pulmonary function testing after RATS-plication showed a mean increase in vital capacity (VC) of 9% (SD 8, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) and of 7% (SD 9, <jats:italic>p<\/jats:italic>\u2009=\u20090.0009) in forced expiratory volume in 1\u00a0s (FEV1) when sitting and 9% (SD 8, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) for VC as well as 10% (SD 8, <jats:italic>p<\/jats:italic>\u2009=\u20090.0001) for FEV1 when in supine position.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>RATS diaphragm plication is a very safe and feasible approach, yielding good results in improving patients\u2019 pulmonary function. Further studies are required to elucidate possible advantages over VATS or open approaches.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00464-023-09942-7","type":"journal-article","created":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T18:02:48Z","timestamp":1678730568000},"page":"4795-4802","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Robotic diaphragm plication: functional and surgical outcomes of a single-center experience"],"prefix":"10.1007","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5671-3048","authenticated-orcid":false,"given":"Uyen-Thao","family":"Le","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurin","family":"Titze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petar","family":"Hundeshagen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernward","family":"Passlick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Severin","family":"Schmid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,3,13]]},"reference":[{"issue":"6","key":"9942_CR1","doi-asserted-by":"publisher","first-page":"S2146","DOI":"10.1016\/j.athoracsur.2010.03.021","volume":"89","author":"SS Groth","year":"2018","unstructured":"Groth SS, Andrade RS (2018) Diaphragm plication for eventration or paralysis: a review of the literature. 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