Laparoscopic Heller myotomy with epiphrenic diverticulectomy.
OBJECTIVE
To describe the technique and results of laparoscopic Heller myotomy and Toupet fundoplication combined with epiphrenic diverticulectomy.


METHODS
A 75-year-old man presented to our institution complaining of dysphagia to solid foods and liquids. The preoperative preparation included a barium swallow, esophagoscopy, and esophageal manometry. Three months earlier, the patient had a botulinum toxin injection, which provided temporary relief. Ten months later, the patient underwent a laparoscopic Heller myotomy and Toupet fundoplication combined with an epiphrenic diverticulectomy.


RESULTS
No complications occurred. The patient tolerated clear liquids on postoperative day 1; on postoperative day 2, he was discharged tolerating full liquids. He returned to full activity in 1 week.


CONCLUSIONS
Epiphrenic diverticulectomy combined with treatment for the underlying motor disorder and gastroesophageal reflux prevention is an accepted practice. We demonstrate that this rare problem can be approached with the laparoscopic technique. Given this favorable result, we plan to continue this technique and establish a longer follow-up and wider series.
Pitchford
Timothy J
TJ
Department of Surgery, Mount Carmel Health System, Columbus, Ohio, USA.
Price
Phillip D
PD
D000368:Aged; D004936:Diverticulum, Esophageal / Q000601:surgery*; D004931:Esophageal Achalasia / Q000601:surgery*; D018662:Fundoplication; D006801:Humans; D010535:Laparoscopy; D008297:Male