Background and Aim: It is difficult to suture an extremely thin and billowed up congenital eventration of the diaphragm thoracoscopically, without insufflation. Materials and Methods: The authors describe their technique using an intestinal clamp to control the redundant tissue and a feeding tube as a flexible knot pusher, to perform the thoracoscopic plication without risking hypercapnia. Results: A satisfactory result was obtained in all the four children. Conclusion: This is a useful adjunctive for thoracoscopic plication of diaphragmatic eventration
