Standardization and Procedural Refinement of a Rabbit Model for Diaphragmatic Defect Creation and Repair: Surgical Technique and Review of Experimental Models

Background and Objectives: Experimental models of diaphragmatic reconstruction vary considerably in defect size, operative access, respiratory management, and repair technique, limiting reproducibility and comparison between studies. This study aimed to describe the technical standardization and procedural refinement of a rabbit model for creation and immediate repair of a limited full-thickness diaphragmatic defect, with particular emphasis on practical challenges identified during its implementation. Materials and Methods: Seventeen male New Zealand White rabbits, aged 3–4 months and weighing 3–4 kg underwent an upper midline transabdominal approach under injectable general anesthesia. A limited full-thickness defect was created in the muscular portion of the left hemidiaphragm and immediately reconstructed with a 2 × 2 cm absorbable polyglactin mesh. Technical aspects of diaphragmatic exposure, defect sizing, mesh fixation, respiratory management, abdominal closure, and postoperative wound protection were systematically documented during implementation and refinement of the model. Results: Four of the 17 rabbits died, corresponding to an observed mortality of 23.5%; two deaths were associated with surgical complications, one was attributed to postoperative ileus, and one remained unexplained. Physiological muscular recoil after diaphragmatic excision required conservative initial tissue resection and measurement of the final defect after contraction, resulting in an approximately 1 × 1 cm defect. Bilateral costal retraction improved operative exposure, while mesh fixation was refined from interrupted sutures to continuous circumferential 3-0 polyglactin fixation with selective reinforcement. Transient air leakage observed during reconstruction resolved after restoration of the abdominal viscera in the absence of persistent respiratory compromise. Postoperative wound manipulation prompted modifications in hair removal, fascial closure, and knot burial. The procedures were completed under injectable anesthesia without routine mechanical ventilation or pleural drainage; physiological stability and adequacy of analgesia were not objectively established. Conclusions: The reported refinements in diaphragmatic exposure, defect sizing, mesh fixation, respiratory assessment, and wound protection provide practical guidance for limited full-thickness diaphragmatic defect creation and repair in rabbits. This technical framework may support protocol development and serve as a practical basis for future experimental evaluation of reconstructive materials and biological adjuncts. However, the observed mortality and limited objective assessment preclude firm conclusions regarding safety and reproducibility, which require further evaluation.