Fig. 1

Diagnosis and treatment for pleuroperitoneal communication in Patient 1. A Chest radiograph taken 2 months after the introduction of peritoneal dialysis. An arrow shows right pleural effusion. B. Port positions in the laparoscopic approach. C Laparoscopic view of the diaphragmatic fistula. An arrow shows a 2-mm-sized fissure in the central tendon of the right diaphragm over the liver. D A thoracic view of the closure of the diaphragmatic fistula using an automatic suture device. An arrow shows the grasped site of the right diaphragm, including the fistula. E Laparoscopic view of the closed site. The arrow shows the suture line. F Chest radiograph taken 3 months after the surgery