Diaphragmatic Resection

Diaphragmatic resection is a surgical procedure in which part or all of the diaphragm, the dome-shaped breathing muscle that separates the chest from the abdomen, is removed, usually because tumor has grown into it. The removed portion is replaced with a synthetic patch (often Gore-Tex or similar mesh) to restore the barrier between the chest and abdominal cavities. It is most commonly performed as part of cytoreductive surgery for pleural mesothelioma.

Origin

The term combines "diaphragm" (from Greek diaphragma, meaning "partition") with "resection" (from Latin resecare, "to cut away"). Diaphragmatic resection as part of mesothelioma surgery was developed and refined in the 1980s–1990s alongside the evolution of extrapleural pneumonectomy (EPP) and later pleurectomy/decortectomy (P/D) techniques by surgeons such as David Sugarbaker at Brigham and Women's Hospital.

Significance in Asbestos Context

Pleural mesothelioma frequently invades the diaphragm because the tumor grows along the lower pleural surface that sits directly on top of this muscle. When surgeons perform EPP or P/D, they often must remove involved sections of the diaphragm to achieve macroscopic complete resection (removing all visible tumor). Whether your surgical pathology report mentions diaphragmatic involvement matters for staging, prognosis, and treatment planning. Diaphragm invasion typically raises the T-stage of the cancer. The need for diaphragmatic resection also signals more advanced local disease and is something patients should discuss carefully with a thoracic surgeon experienced in mesothelioma, ideally at a high-volume center.

Example Sentence

The operative report noted that the surgeon performed a pleurectomy/decortication with en bloc diaphragmatic resection and reconstruction using a Gore-Tex patch.

Related Terms

Extrapleural Pneumonectomy, Pleurectomy/Decortication, Cytoreductive Surgery, Pleural Mesothelioma, Macroscopic Complete Resection, Pericardial Resection

Notes

• Ask your surgical team whether your operative and pathology reports document diaphragmatic involvement and the margin status. These details affect staging and may be cited by medical experts in your claim.
• Request copies of your operative report, pathology report, and post-operative imaging; these are key records both for ongoing care and for any legal case involving mesothelioma.
• If diaphragmatic resection is being considered, ask about the surgeon's annual mesothelioma case volume and whether the procedure will be combined with hyperthermic intraoperative chemotherapy (HIOC/HITHOC) or followed by systemic therapy.
• Be aware that patch reconstruction can occasionally develop complications such as hernia, infection, or patch dehiscence. Report new abdominal or breathing symptoms promptly.