Abstract
Introduction
Traditionally, epiphrenic diverticula have been managed through a left thoracotomy. With the advancement of minimally invasive techniques, a laparoscopic approach has gained widespread popularity. Unfortunately, the preoperative evaluation of patients with epiphrenic diverticula, and their surgical management, is still not well characterized.
Discussion
The goal of this article is to illustrate our approach to patients with epiphrenic diverticula in terms of preoperative evaluation and surgical technique. The final discussion will focus on the evidence-based rationale for our preoperative assessment and surgical approach.
Similar content being viewed by others
References
Del Genio A, Rossetti G, Maffetton V, Renzi A, Brusciano L, Limongelli P, Cuttitta D, Russo G, Del Genio G. Laparoscopic approach in the treatment of epiphrenic diverticula: long-term results. Surg Endosc. 2004;18(5):741–5
Streitz JM, Glick ME, Ellis H. Selective use of myotomy for treatment of epiphrenic diverticula. Manometric and clinical analysis. Arch Surg 1992;127(5):585–8
Altorki N, Sunagawa M, Skinner D. Thoracic esophageal diverticula. Why is the operation necessary? J Thorac Cardiovasc Surg 1993;105(2):260–4
Benacci JC, Deschamps C, Trastek V, Allen MS, Daly RC, Pairolero PC. Epiphrenic diverticulum: results of surgical treatment. Ann Thorac Surg 1993;55(5):1109–14
Nehra D, Lord RV, DeMeester TR, Theisen J, Peters JH, Crookes PF, Bremner CG. Physiologic basis for the treatment of epiphrenic diverticulum. Ann Surg. 2002;235(3):346–54
Varghese TK Jr, Marshall B, Chang AC, Pickens A, Lau CL, Orringer MB. Surgical treatment of epiphrenic diverticula: a 30-year experience. Ann Thorac Surg. 2007;84(6):1801–9
Rosati R, Fumagalli U, Elmore U, de Pascale S, Massaron S, Peracchia A. Long-term results of minimally invasive surgery for symptomatic epiphrenic diverticulum. Am J Surg. 2011;201(1):132–5
Klaus A, Hinder RA, Swain J, Achem SR. Management of epiphrenic diverticula. J Gastrointest Surg. 2003;7(7):906–11
Melman L, Quinlan J, Robertson B, Brunt LM, Halpin JV, Eagon JC, Frisella MM, Matthews BD. Esophageal manometric characteristics and outcomes for laparoscopic esophageal diverticulectomy, myotomy, and partial fundoplication for epiphrenic diverticula. Surg Endosc 2009;23(6):1337–41
Tedesco P, Fisichella PM, Way LW, Patti MG. Cause and treatment of epiphrenic diverticula. Am J Surg. 2005;190(6):891–4
Fernando HC, Luketich JD, Samphire J, Alvelo-Rivera M, Christie NA, Buenaventura PO, Landreneau RJ. Minimally invasive operation for esophageal diverticula. Ann Thorac Surg. 2005;80(6):2076–80.
Evander A, Little AG, Ferguson MK, Skinner DB. Diverticula of the mid- and lower esophagus: pathogenesis and surgical management. World J Surg. 1986 Oct;10(5):820–8
Castrucci G, Porziella V, Granone PL, Picciocchi A. Tailored surgery for esophageal body diverticula. Eur J Cardiothorac Surg. 1998;14(4):380–7
Kilic A, Schuchert MJ, Awais O, Luketich JD, Landreneau RJ. Surgical management of epiphrenic diverticula in the minimally invasive era. JSLS. 2009;13(2):160–4
Soares R, Herbella FA, Prachand VN, Ferguson MK, Patti MG. Epiphrenic diverticulum of the esophagus. From pathophysiology to treatment. J Gastrointest Surg. 2010;14(12):2009–15
Thomas ML, Anthony AA, Fosh BG, Finch JG, Maddern GJ. Oesophageal diverticula. Br J Surg. 2001 May;88(5):629–42
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Fisichella, P.M., Pittman, M. & Kuo, P.C. Laparoscopic Treatment of Epiphrenic Diverticula: Preoperative Evaluation and Surgical Technique. How I Do It. J Gastrointest Surg 15, 1866–1871 (2011). https://doi.org/10.1007/s11605-011-1631-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11605-011-1631-6