Premier Center for the Treatment of Diaphragm Disorders
For most of us, breathing is a reflex, requiring little or no thought. It’s something we do automatically, between 17,000 and 30,000 times a day. Yet this simple act depends upon the diaphragm, a dome-like muscle separating the chest cavity and the abdomen. When you breathe, this muscle contracts and moves downward, increasing the space around your lungs, leaving more room for them to inflate.
When the diaphragm is impaired or paralyzed, breathing becomes labored, difficult. Severely ill patients have to rely upon a ventilator, a machine that removes carbon dioxide from the body and forces oxygen into the lungs.
“There are many degrees of impairment,” says Dr. Mark Ginsburg, co-director of the Diaphragm Center at NYP/Columbia with Dr. Keith Brenner. “Patients with paralysis on both sides of diaphragmatic may have a 70-80 percent reduction in their lung capacity while those with paralysis one side may have a 50 percent reduction.”
The good news is that safe and minimally invasive surgical procedures can bring significant relief to those with diaphragm paralysis.
Founded in 2017, the Diaphragm Center the only program in the world dedicated to disorders of the diaphragm, a major cause of respiratory insufficiency in children and adults.
“We’ve been spreading the word, and In the past year, we have become the premier center for the treatment of diaphragm disorders,” says Dr. Ginsburg, “Our patients come from across the country and around the globe. And we help everyone struggling with this problem—from those with central sleep apnea to those on respirators after traumatic injuries, neuromuscular diseases or diaphragm impairment due to birth trauma.”
The Diaphragm Center uses VATS (video-assisted thoracic surgery) and robotic techniques to correct diaphragm disorders. Recovery time is minimal. Operating time is less than an hour and most patients go home the next day.
- A procedure called a minimally-invasive plication tightens the diaphragm and sets it in a lower position, greatly increasing the resting size of the lungs. After this procedure, most patients experience a 35% improvement in lung function. When exercising, they are less short of breath and have greater reserves.
- The insertion of a phrenic pacemaker can help a smaller group of patients—paraplegics and victims of traumatic injury breathe without the aid of a respirator, by signaling the diaphragm to contract and make space for the lungs. This type of surgery is also helpful for patients suffering from multiple sclerosis, muscular dystrophy or ALS (Lou Gehrig’s disease.)
“The majority of our patients benefit significantly from plication.” Says Dr. Ginsburg. “They come to us because they are short of breath. They can’t lie down or sleep in a prone position, or bend down to tie their shoes without struggling. Often just one side of their diaphragm is affected. Safe, and minimally invasive, surgical procedures can bring a cure with a relatively simple surgery, with little down time, and give these people back the breath of life.”