Skip to main content
Log in

Laparoscopic management of symptomatic achalasia associated with epiphrenic diverticulum

  • Original article
  • Published:
Surgical Endoscopy And Other Interventional Techniques Aims and scope Submit manuscript


Background: We evaluated outcome after laparoscopic esophageal diverticulectomy, myotomy, and partial fundoplication. Methods: Patients with symptomatic achalasia and epiphrenic diverticula underwent laparoscopic diverticulectomy, Heller myotomy, and partial fundoplication. Intraoperative endoscopy and postoperative esophagography were performed in all patients. Patients graded preoperative and postoperative dysphagia and heartburn on a Likert scale. Results: Anterior fundoplication was performed in five patients and posterior fundoplication in one. Mean follow-up was 9 months (range, 1–17 months). One intraoperative complication occurred—an esophagotomy that was laparoscopically repaired. There were no postoperative leaks. Patient-reported dysphagia decreased from 4.5 ± 0.8 (mean ± SD) to 1.8 ± 1.7 (p < 0.05 matched pair analysis). Heartburn decreased from 4.3 ± 0.8 to 1.3 ± 1.3 (p < 0.05). All patients reported improvement in symptoms after operation. Conclusion: Laparoscopic esophageal diverticulectomy, Heller myotomy, and partial fundoplication with intraoperative endoscopy safely reduce dysphagia associated with achalasia and esophageal diverticula while limiting symptoms of gastroesophageal reflux.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. NK Altorki M Sunagawa DB Skinner (1993) ArticleTitleThoracic esophageal diverticula. Why is operation necessary? J Thorac Cardiovasc Surg 105 260–264 Occurrence Handle1:STN:280:ByyC2MnjtFA%3D Occurrence Handle8429653

    CAS  PubMed  Google Scholar 

  2. JC Benacci C Deschamps VF Trastek MS Alien RC Daly PC Pairolero (1993) ArticleTitleEpiphrenic diverticulum: results of surgical treatment. Ann Thorac Surg 55 1109–1113 Occurrence Handle1:STN:280:ByyB28zntFc%3D Occurrence Handle8494418

    CAS  PubMed  Google Scholar 

  3. M Bloomston W Boyce J Mamel M Albrink M Murr A Durkin A Rosemurgy (2000) ArticleTitleVideoscopic Heller myotomy for achalasia—results beyond short-term follow-up. J Surg Res 92 150–156 Occurrence Handle10.1006/jsre.2000.5886 Occurrence Handle1:STN:280:DC%2BD3czpslOqtg%3D%3D Occurrence Handle10896815

    Article  CAS  PubMed  Google Scholar 

  4. M Bloomston P Brady AS Rosemurgy (2002) ArticleTitleVideoscopic Heller myotomy with intraoperative endoscopy promotes optimal outcome. JSLS 6 133–138 Occurrence Handle12113416

    PubMed  Google Scholar 

  5. M Bloomston F Serafini W Boyce AS Rosemurgy (2002) ArticleTitleThe “learning curve” in videoscopic Heller myotomy. JSLS 6 41–47 Occurrence Handle12002295

    PubMed  Google Scholar 

  6. M Bloomston F Serafini AS Rosemurgy (2001) ArticleTitleVideoscopic Heller myotomy as first-line therapy for severe achalasia. Am Surg 67 1105–1109 Occurrence Handle1:STN:280:DC%2BD3MnosVaksQ%3D%3D Occurrence Handle11730231

    CAS  PubMed  Google Scholar 

  7. G Castrucci V Porziella PL Granone A Picciocchi (1998) ArticleTitleTailored surgery for esophageal body diverticula. Eur J Cardiothorac Surg 14 380–387

    Google Scholar 

  8. Z Chami JM Fabre F Navarro J Domergue (1999) ArticleTitleAbdominal laparoscopic approach for thoracic epiphrenic diverticulum. Surg Endosc 13 164–165 Occurrence Handle10.1007/s004649900930 Occurrence Handle1:STN:280:DyaK1M7hslCrtA%3D%3D Occurrence Handle9918622

    Article  CAS  PubMed  Google Scholar 

  9. TR Eubanks CA Pellegrini (1999) ArticleTitleMinimally invasive treatment of esophageal diverticula. Semin Thorac Cardiovasc Surg 11 363–369 Occurrence Handle1:STN:280:DC%2BD3c%2FgsVSgtA%3D%3D Occurrence Handle10535378

    CAS  PubMed  Google Scholar 

  10. JT Mondiere (1833) ArticleTitleNotes sue quelques maladies de l’ oesophage. Arch Gen Med Paris 3 28

    Google Scholar 

  11. B Moynihan (1927) ArticleTitleDiverticula of the alimentary canal. Lancet 1 1061

    Google Scholar 

  12. BS Myers DT Dempsey (1998) ArticleTitleLaparoscopic resection of esophageal epiphrenic diverticulum. J Laparoendosc Adv Surg Tech 8 201–207 Occurrence Handle1:STN:280:DyaK1cvislensA%3D%3D

    CAS  Google Scholar 

  13. R Rosati U Fumagalli S Bona L Bonavina A Peracchia (1998) ArticleTitleDiverticulectomy, myotomy, and fundoplication through laparoscopy: a new option to treat epiphrenic esophageal diverticula? Ann Surg 227 174–178 Occurrence Handle10.1097/00000658-199802000-00004 Occurrence Handle1:STN:280:DyaK1c7kslygtQ%3D%3D Occurrence Handle9488513

    Article  CAS  PubMed  Google Scholar 

  14. ML Thomas AA Anthony BG Fosh JG Finch GJ Maddern (2001) ArticleTitleOesophageal diverticula. Br J Surg 88 629–642 Occurrence Handle10.1046/j.1365-2168.2001.01733.x Occurrence Handle1:STN:280:DC%2BD3M3lt1aqsQ%3D%3D Occurrence Handle11350433

    Article  CAS  PubMed  Google Scholar 

  15. PP Vinson (1934) ArticleTitleDiverticula of the thoracic portion of the esophagus: report of 42 cases. Arch Otolaryngol 19 508

    Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to A. S. Rosemurgy.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fraiji, E., Bloomston, M., Carey, L. et al. Laparoscopic management of symptomatic achalasia associated with epiphrenic diverticulum . Surg Endosc 17, 1600–1603 (2003).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: