Robotic reconstruction of a left hemi-diaphragm defect with double mesh in a patient with trisomy 21

Robotic reconstructions of large diaphragmatic defects with mesh reconstructions are rare in the literature. We present a case of a complicated diaphragmatic defect, in an adult with trisomy 21, which was successfully repaired robotically with double mesh reinforcement. The meshes were sutured together via a separate suture in the middle to avoid fluid accumulation between them. The patient recovered quickly and uneventfully. On follow-up, he reported no pain, and his performance score improved dramatically. We present this complicated reconstruction in this specific patient, who we think benefitted from avoiding a thoraco-abdominal incision, demonstrating the merits of persevering with a robotic approach.