Transthoracic robot-assisted minimally invasive diaphragmatic rupture repair: a case report

BACKGROUND: Nontraumatic diaphragmatic rupture is a rare condition with clinical presentations ranging from asymptomatic to severe respiratory or gastrointestinal symptoms. Owing to its nonspecific nature, it can be difficult to differentiate from other diaphragmatic disorders. CASE PRESENTATION: We present a case of a 35-year-old German woman with a right-sided nontraumatic diaphragmatic rupture, presenting with recurrent hypertensive crises and acute dyspnea. Although initially misdiagnosed, further clinical and radiological evaluations suggestive of diaphragmatic elevation led to the decision to proceed with robot-assisted thoracoscopic surgery. CONCLUSION: This case underscores the diagnostic challenges of non-traumatic diaphragmatic rupture, especially in complex clinical scenarios. It highlights the importance of thorough clinical assessment, appropriate imaging, and timely surgical intervention. Robot-assisted thoracoscopic surgery proved to be a safe and effective therapeutic option and should be considered in select cases where conventional diagnostics fail to provide definitive answers.