Medical Oncologist
CION Cancer Clinics
Diaphragm resection and repair in cancer surgery | CION Cancer Clinics
A diaphragm resection removes the part of the diaphragm that a cancer has grown into, with a rim of healthy muscle, and then closes the gap with stitches or a patch. It is done when a tumour from the lung, chest wall, chest lining or upper belly has reached the muscle. This page explains why it is done, how the repair works, what recovery involves and what to ask. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- What is a diaphragm resection in cancer surgery?
- Which cancers can involve the diaphragm?
- How is the diaphragm removed and repaired?
- What do the words on the surgery notes mean?
- How will breathing and recovery be affected?
- What do families often get wrong about this operation?
- What can this page not tell you?
- Common questions about diaphragm resection
The short answer
What is a diaphragm resection in cancer surgery?
A diaphragm resection removes the part of the diaphragm that a tumour has grown into or stuck to, along with a rim of healthy muscle around it. The gap is then closed with stitches or bridged with a patch, so the muscle can go on helping you breathe.
What the diaphragm does
The diaphragm is the dome of muscle that separates the chest from the belly. When it tightens and flattens, the lungs are pulled open and air comes in. It also keeps the stomach, liver and bowel below it, out of the chest.
Why a surgeon would remove part of it
Cancers do not stop at the edge of an organ. A tumour in the lung, the chest wall, the lining of the chest or the upper belly can reach the diaphragm. When the aim is to take out all visible cancer, the attached piece of diaphragm has to come out with the tumour in one piece rather than being peeled off it.
Who it does not suit
It is not offered when the cancer has already spread widely, when removing it would leave cancer behind elsewhere, or when the heart and lungs are not strong enough for a long operation. Your team weighs these before surgery is suggested.
Where it comes from
Which cancers can involve the diaphragm?
The tumour can reach the diaphragm from above, from below or from the muscle itself. Where it started changes how the operation is planned.
From the chest
A lung cancer at the base of the lung, or a tumour growing through the lower ribs, can press into the top of the diaphragm.
Often seen with
- Lower lobe lung cancers
- Chest wall sarcomas
From the lining of the chest
Mesothelioma, a cancer of the thin lining around the lungs, often spreads across the top of the diaphragm. Surgery for it may remove a large part of the muscle.
From the belly
Cancers of the ovary, liver, stomach or the lining of the belly can settle on the underside of the diaphragm. These deposits are often removed during a larger abdominal operation.
From the muscle itself
Tumours that start in the diaphragm are rare. When they happen they are usually a type of sarcoma, which means a cancer of muscle or other soft tissue.
Not sure whether this applies to you?
Ask an oncologistIn the operating theatre
How is the diaphragm removed and repaired?
Reaching the tumour
The surgeon opens the chest, the belly, or occasionally both, depending on where the cancer sits. You are fully asleep under a general anaesthetic throughout.
Removing it in one piece
The tumour and the attached diaphragm come out together, with a margin of healthy muscle. Nearby tissue it has stuck to, such as lung or ribs, may be removed at the same time.
Closing a small gap
If only a small piece was taken, the cut edges are stitched directly together. This keeps the muscle's own strength and movement on that side.
Patching a larger gap
A larger gap is closed with a patch of synthetic mesh or a sheet of tissue. The patch keeps the belly organs from moving up into the chest, and a drain is usually left in place for a few days.
On your report
What do the words on the surgery notes mean?
- Hemidiaphragm
- One half of the diaphragm, left or right. Most resections involve only one side.
- Phrenic nerve
- The nerve that makes the diaphragm move. If it has to be cut, that side of the muscle stops working and sits higher on an X-ray.
- En bloc
- Removed in one piece, so no cancer is spilled or left at a cut surface.
- Margin
- The rim of healthy tissue around what was removed. A clear margin means no cancer cells were seen at the edge.
- Herniation
- Belly organs pushing up through a weak spot into the chest. The repair is designed to stop this.
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After the operation
How will breathing and recovery be affected?
Most people breathe well enough for daily life after a diaphragm resection, because the other side of the diaphragm and the chest muscles take on more of the work. Breathing feels harder at first, and it improves over the following weeks as you move about.
The first days
You may spend the first night or two in intensive care or a high-dependency unit. A chest drain removes fluid and air. The physiotherapist will have you breathing deeply and coughing from the first day, because shallow breathing lets the lung base close down.
What can go wrong
The problems your surgeon will discuss include chest infection, fluid collecting around the lung, a patch that becomes infected, and belly organs slipping through a weak repair later on. Your team will explain how likely these are for your own operation, which depends heavily on what else was removed.
If the nerve was cut
When the phrenic nerve is removed, that half of the diaphragm no longer moves. Some people notice breathlessness when lying flat or bending. The surgeon may tighten the muscle so it does not rise into the chest with each breath.
Sudden breathlessness, chest pain or vomiting after you are home needs a same-day call to your surgical team.Commonly believed
What do families often get wrong about this operation?
"Without part of the diaphragm, you cannot breathe."
The diaphragm is a large muscle with two halves, and breathing does not depend on one section of it. The remaining muscle and the chest wall keep working. A repaired diaphragm still lets most people walk, talk and sleep normally once recovered.
"If the cancer has reached the diaphragm, surgery is pointless."
Reaching the diaphragm does not always mean the cancer has spread far. For some tumours the diaphragm is simply the next thing it touched, and removing both together is the planned treatment. The scans and the tumour board decide this, not the location alone.
"The mesh patch will need replacing every few years."
A patch is meant to stay in place for life. The body grows scar tissue into and around it. It is only removed if it becomes infected or the repair fails, and your surgeon will tell you what signs to watch for.
Being straight with you
What can this page not tell you?
This page cannot tell you whether a diaphragm resection is right for you or your parent. That decision belongs to the treating team, who can see the scans, the biopsy and the fitness tests together.
It cannot tell you how the operation will go
The same name covers a small stitched repair and a large operation that also removes lung, lining and ribs. Recovery and risk differ widely between them. Ask your surgeon which one is being planned.
Questions worth taking to the appointment
Ask how much of the diaphragm is likely to come out, and whether the nerve can be kept. Ask whether the gap will be stitched or patched, and what the patch is made of. Ask what other organs may be removed, where you will recover in the first days, and what treatment may follow surgery.
Bring every scan and report, including older ones. They help the surgeon see how the tumour has changed.Questions we are asked
Common questions about diaphragm resection
Is diaphragm resection a major operation?
Usually, yes. It is done under general anaesthetic, often alongside removal of lung, ribs or a belly organ, and it needs a hospital stay with close monitoring in the first days. How major it is for you depends on what else is removed, which your surgeon can explain from the scans.
Will I feel short of breath for the rest of my life?
Most people find their breathing settles enough for ordinary daily life. Heavy exercise or climbing many stairs may feel harder than before, especially if the nerve on that side was cut or part of the lung was also removed. Breathing exercises and walking help the remaining muscles adapt.
Can the patch move or tear?
It is uncommon, but it can happen. A repair can loosen, and belly organs can push through a gap. Signs include new pain in the chest or upper belly, vomiting, or sudden breathlessness. These need a same-day call to your surgical team rather than waiting for the next review.
Will I need chemotherapy or radiotherapy afterwards?
That depends on the type of cancer and what the pathology report shows about the margins and lymph nodes, which are the small glands that filter fluid from the tissues. Some people have treatment before surgery, some after, and some neither. The tumour board will discuss it once the report is ready.
How long does the operation take?
It varies a great deal. A small resection with a stitched repair is much shorter than an operation that also removes lung or chest wall. Your surgeon can give you an idea for your own plan.
Can I eat normally after a diaphragm repair?
Most people return to normal eating. In the first weeks, smaller meals can feel more comfortable, because a full stomach presses up against the repaired muscle. If eating brings on pain, vomiting or breathlessness, tell your surgical team the same day.
Should my father have this surgery at his age?
Age alone does not decide it. The team looks at his heart and lung function, his daily activity, other illnesses and what the cancer is doing. Ask them to explain the benefits and the risks for him specifically, and what the other options would be if he chose not to have the operation.
Is it covered by Aarogyasri or insurance?
Cancer surgery is often covered when it is part of an approved treatment plan. Aarogyasri, CGHS, ECHS and EHS are accepted, and most cashless insurers are empanelled. What your own card or policy pays depends on its limits, so ask for a written estimate before admission.
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MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Dr. Vinay Mamidala
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Dr. Vajja Sandeep Kumar
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Sources
- Cancer Research UK — Surgery for mesothelioma
- NHS — Mesothelioma
- National Cancer Institute — Surgery to Treat Cancer
- American Cancer Society — Surgery for ovarian cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Chest Wall Resection: What Is RemovedEvery layer the wider operation can involveChest Wall Reconstruction: Mesh and FlapsHow patches and flaps close a gapBreathing and Chest Movement After ReconstructionWhat breathing feels like in the months afterICU and the First Days After SurgeryWhat the first nights in hospital involveComplications and Red FlagsSigns at home that need a same-day call
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Been told the diaphragm may need to be removed?
Send us the scan report or call the helpline. A surgical oncologist will explain what is being proposed and what to ask. One helpline serves every CION centre.