Diaphragm Plication in Adults With Phrenic Nerve Paralysis

Inclusion Criteria: * Uni- or bilateral diaphragmatic paralysis due to phrenic nerve paralysis present for at least 1 year * With reduced VC, at least in supine position and no significant change in VC for at least 6 months * At the time of randomisation symptomatic patient, defined by one of the following symptoms: not able to sleep in supine position or exertional dyspnoea Exclusion Criteria: * No informed consent obtained * Other disease that may interfere with the evaluation of pulmonary function or the exercise capacity: COPD, parenchymal lung disease on the thoracic X-ray, documented ischemic heart disease or left heart failure, active rheumatological disease, severe orthopaedic problems,.... * Abnormal neuromuscular clinical investigation (apart from diaphragmatic dysfunction) and/or abnormal electromyography of the limbs compatible with generalized neuromuscular disease * Known diseases resulting in abnormal blood coagulation * Proven oncological origine of the phrenic nerve paralysis * Age below 18 yrs old