Dr. Raymond Onders is Professor of Surgery at University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine in Cleveland, Ohio. He is honored with the Walter and Margaret Remen Chair of Surgical Innovation. 

Over the last 25 years, he has focused his research efforts on ways to help people breathe naturally using their own diaphragm. He has authored multiple publications and book chapters on the primary muscle of breathing –- the diaphragm. He has trained surgeons around the world on the technique of diaphragm pacing to allow patients freedom from tracheostomy mechanical ventilation.

Diaphragm pacing, electrical stimulation of the diaphragm muscle, is a technology aimed at either replacing or delaying the need for mechanical ventilation or maintaining and improving normal breathing. One of his first research subjects was the late Christopher Reeve (Superman). Diaphragm pacing technology was recognized as one of the most important medical innovations at the 6th Medical Innovation Summit in 2008. Dr. Onders’ advancements in the technology of pacing the diaphragm have led to multiple patents. He co-founded the medical device company Synapse Biomedical which helped to bring this technology to patients.

Dr. Onders has given invited lectures around the world and presented his research at numerous scientific meetings. He has helped spread this knowledge training surgeons to do the diaphragm pacing operation in over 35 countries which has helped countless patients worldwide. His present research focuses on using diaphragm pacing to shorten the time to wean from a ventilator on all intensive care unit patients which is one of the largest health care expenditures in the United States. With the possibility of a shortage of ventilators early in the COVID-19 pandemic, he worked and obtained emergency use authorization by the FDA of the new temporary pacing system in April of 2020. This has led to multiple new applications of the use of temporary diaphragm pacing wires to decrease ventilator times significantly in high risk cardiac patients and lung transplant patients.

He earned his M.D. at Northeastern Ohio Universities College of Medicine in 1988, and in 2010 he received the Distinguished Alumni Award, its highest honor, for his work in advancing medicine. Dr. Onders joined the University Hospitals staff in 1997, following his service with the military where he was a Major in the United States Air Force. He is active in many medical and surgical organizations and has been President of Midwest Surgical Association and Cleveland Surgical along with being on the Board of several large surgical organizations. He was inducted as a fellow in the American Spinal Injury Association in 2019. Among his multiple other honors, include the Maurice Saltzman Award presented on behalf of the Mount Sinai Health Care Foundation, Crain’s Cleveland Business 2008 Health Care Heroes for Advancements in Health, the Rescuer of Humanity Award presented by Values in Action Foundation, and the ALS Association’s Bob Feller Legacy Award in 2013 for his work with Lou Gehrig’s disease.

Dr. Onders is an expert on providing therapies for patients with diaphragmatic abnormalities from spinal cord injured patients who cannot breathe to patients with unilateral diaphragm problems from injured phrenic nerves from cardiac surgery, lung transplant and even the effects on the diaphragm from COVID-19. This technology he helped develop has also been used in numerous pediatric applications.

Publications (Select)

Entire publication list can be found here.

  • Onders RP, Markowitz A, Ho VP, Hardacre J, Novitsky Y, Towe C, Elmo M, Kaplan C, Schilz R. Completed FDA feasibility trial of surgically placed temporary diaphragm pacing electrodes: A promising option to prevent and treat respiratory failure. Am J Surg. 2018 Mar;215(3):518–521. doi: 10.1016/j.amjsurg.2017.10.054 Pubmed PMID: 29195690
  • Smith BK, Fuller DD, Martin AD, Lottenberg L, Islam S, Lawson LA, Onders RP, Byrne BJ. Diaphragm Pacing as a Rehabilitative Tool for Patients With Pompe Disease Who Are Ventilator-Dependent: Case Series. Phys Ther. 2016 May;96(5):696-703. doi: 10.2522/ptj.20150122. Epub 2016 Feb 18. PubMed PMID: 26893511; PubMed Central PMCID: PMC4858660.
  • Onders RP, Elmo M, Kaplan C, Katirji B, Schilz R. Identification of unexpected respiratory abnormalities in patients with amyotrophic lateral sclerosis through electromyographic analysis using intramuscular electrodes implanted for therapeutic diaphragmatic pacing. Am J Surg. 2015 Mar;209(3):451-6. doi: 10.1016/j.amjsurg.2014.10.008. Epub 2014 Dec 11. PubMed PMID: 25648901.
  • Onders RPThe diaphragm: how it affected my career and my life. The search for stability when the problem is instability. Am J Surg. 2014 Dec 18. pii: S0002-9610(14)00620-5. doi: 10.1016/j.amjsurg.2014.12.003. [Epub ahead of print] PubMed PMID: 25637310.
  • Onders RP, Elmo M, Kaplan C, Katirji B, Schilz R. Identification of unexpected respiratory abnormalities in patients with amyotrophic lateral sclerosis through electromyographic analysis using intramuscular electrodes implanted for therapeutic diaphragmatic pacing. Am J Surg. 2014 Dec 11. pii: S0002-9610(14)00598-4. doi: 10.1016/j.amjsurg.2014.10.008. [Epub ahead of print] PubMed PMID: 25648901.
  • Onders RP, Elmo M, Kaplan C, Katirji B, Schilz R. Final analysis of the pilot trial of diaphragm pacing in amyotrophic lateral sclerosis with long-term follow-up: diaphragm pacing positively affects diaphragm respiration. Am J Surg. 2014 Mar;207(3):393-7; discussion 397. doi: 10.1016/j.amjsurg.2013.08.039. Epub 2013 Dec 19. PubMed PMID: 24439161.
  • Posluszny JA Jr, Onders R, Kerwin AJ, Weinstein MS, Stein DM, Knight J, Lottenberg L, Cheatham ML, Khansarinia S, Dayal S, Byers PM, Diebel L. Multicenter review of diaphragm pacing in spinal cord injury: successful not only in weaning from ventilators but also in bridging to independent respiration. J Trauma Acute Care Surg. 2014 Feb;76(2):303-9; discussion 309-10. doi: 10.1097/TA.0000000000000112. PubMed PMID: 24458038.
  • Marks JM, Phillips MS, Tacchino R, Roberts K, Onders R, DeNoto G, Gecelter G, Rubach E, Rivas H, Islam A, Soper N, Paraskeva P, Rosemurgy A, Ross S, Shah S. Single-incision laparoscopic cholecystectomy is associated with improved cosmesis scoring at the cost of significantly higher hernia rates: 1-year results of a prospective randomized, multicenter, single-blinded trial of traditional multiport laparoscopic cholecystectomy vs single-incision laparoscopic cholecystectomy. J Am Coll Surg. 2013 Jun;216(6):1037-47; discussion 1047-8. doi: 10.1016/j.jamcollsurg.2013.02.024. Epub 2013 Apr 23. PubMed PMID: 23619321.
  • Phillips MS, Marks JM, Roberts K, Tacchino R, Onders R, DeNoto G, Rivas H, Islam A, Soper N, Gecelter G, Rubach E, Paraskeva P, Shah S. Intermediate results of a prospective randomized controlled trial of traditional four-port laparoscopic cholecystectomy versus single-incision laparoscopic cholecystectomy. Surg Endosc. 2012 May;26(5):1296-303. doi: 10.1007/s00464-011-2028-z. Epub 2011 Nov 15. PubMed PMID: 22083331.
  • Gonzalez-Bermejo J, Morélot-Panzini C, Salachas F, Redolfi S, Straus C, Becquemin MH, Arnulf I, Pradat PF, Bruneteau G, Ignagni AR, Diop M, Onders R, Nelson T, Menegaux F, Meininger V, Similowski T. Diaphragm pacing improves sleep in patients with amyotrophic lateral sclerosis. Amyotroph Lateral Scler. 2012 Jan;13(1):44-54. doi: 10.3109/17482968.2011.597862. Epub 2011 Oct 24. PubMed PMID: 22023158.
  • Onders RP. Functional electrical stimulation: restoration of respiratory function. Handb Clin Neurol. 2012;109:275-82. doi: 10.1016/B978-0-444-52137-8.00017-6. Review. PubMed PMID: 23098719.


Walter and Margaret Remen Chair of Surgical Innovation
University Hospitals Cleveland Medical Center

Professor of Surgery
University Hospitals Cleveland Medical Center

Professor of Surgery
Case Western Reserve University School of Medicine

Cleveland FES Center


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Raymond Onders

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(216) 844-5797

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