Laparoscopic Management of Epiphrenic Esophageal Diverticulum with Intraoperative Endoscopy
Eugenius J. Harvey, Kervin Arroyo, Peter Rubin, Lester B. Katz, Anthony J. Vine*
Dept of Surgery, Mount Sinai School of Medicine, New York, NY
We present the case of a 71-year-old female with a five month history of dysphagia, weight loss and heartburn. Preoperative investigation with barium swallow and upper endoscopy demonstrated a large lower esophageal pulsion divertictulum. A laparoscopic transhiatal resection of the esophageal diverticulum was performed with Heller myotomy and crural repair. Intraoperative endoscopy helps to identify the diverticulum in the mediastinum, to ensure complete resection of the diverticulum, to ensure an adequate esophageal myotomy, and to perform an air leak test. A Heller myotomy is performed to treat the esophageal dysmotility. A fundoplication is not performed due to poor esophageal motility.
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