Thoracoscopic intercostal to phrenic nerve transfer for diaphragmatic reanimation in a child with tetraplegia

This case report describes a new surgical technique to help a child with tetraplegia (paralysis in all four limbs) breathe more easily. The technique involves transferring a nerve from the chest wall (intercostal nerve) to the nerve that controls the diaphragm (phrenic nerve). The goal of this surgery is to reanimate the diaphragm, which is the main muscle used for breathing. By restoring the function of the diaphragm, the patient may be able to reduce or eliminate their dependence on a ventilator. The procedure was performed using minimally invasive techniques (thoracoscopy), which involves making small incisions in the chest and using a camera and specialized instruments to perform the surgery.

• 1
  The patient, a 5-year-old female with tetraplegia and ventilator dependence, was able to achieve ventilator independence two years after undergoing thoracoscopic intercostal to phrenic nerve transfer.
• 2
  Post-operative M-mode ultrasonography showed marked improvement with diaphragmatic excursion of 2.1 cm on the left and 3 cm on the right.
• 3
  The described thoracoscopic approach for nerve transfer and pacing was found to be both safe and effective for restoring innervation of the diaphragm in a child.