Laparoscopic resection of an epiphrenic diverticulum
Epublication WebSurg.com, May 2015;15(05). URL: http://websurg.com/doi/vd01en4487
This video shows a laparoscopic resection of a large epiphrenic diverticulum and an esophageal myotomy with partial posterior fundoplication. Abdominal obesity as well as an accessory left hepatic artery originating from the left gastric artery make dissection of the right para-esophageal area difficult. An anterior phrenotomy as well as the posterior retro-esophageal dissection towards the aorta make dissection of the diverticulum possible. The upper limit of the diverticulum is strongly attached to the esophagus and the pleura, and its dissection is difficult. After complete dissection of the diverticulum and with the guidance of an intraoperative endoscopy, resection is performed. As it is believed that an underlying motility disorder is present, a distal esophageal myotomy and partial fundoplication is added. The postoperative course was uneventful and the patient has no remaining symptoms.