Figure 2

The most flaccid part of the diaphragm can be identified under thoracoscopy (the green arrow in 2A). After confirming the edge to be sutured, we started plication from a more medial part of the diaphragm (B) and then continued the procedure to a more lateral part of the diaphragm (C). The overall view of the diaphragm after plication is shown in (D).