[Endoscopic assisted endoluminal stapler-diverticulotomy of Zenker diverticulum].
BACKGROUND
One of the advantages of endoluminal diverticolotomy in Zenker's diverticulum with the staple is the possibility of early rehabilitation. As the stapler allows to close the cut wound margins of the diverticulum threshold simultaneously with a clip suture, the patient can start oral food intake as early as 24 hours after surgery. The overview for the surgeon for correct placement of the clip device is limited due to the physiological narrowness of the pharyngeal tube.


METHODS
We reduced the danger of malplacement by placing a temporary stomach tube as well as endoscopic control of the position of the stapler at the diverticulum threshold.


RESULTS
61 patients with Zenker's diverticulum stage Brombart I - IV have been successfully treated with this surgery technique since 1998. In two other patients a transcervical diverticulotomy was done because the diverticulum threshold could not be exposed clearly with the spread laryngoscope. In 10 patients a clinically symptomatical recurrent diverticulum (Brombart stage II) could be safely removed by a repeated endoscopically assisted stapler diverticulotomy.


CONCLUSIONS
The advanced endoscopically assisted endoluminal stapler diverticulotomy in Zenker's diverticulum is convenient for the patient allowing prompt food intake and showing low morbidity and no mortality.
Schipper
J
J
Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde und Poliklinik, Universitätsklinikum Freiburg, Killianstrasse 5, D-79106 Freiburg, Germany. schipper@hno.ukl.uni-freiburg.de
Weerda
N
N
Aschendorff
A
A
Maier
W
W
Ridder
G J
GJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004435:Eating; D004724:Endoscopy; D006801:Humans; D007441:Intubation, Gastrointestinal; D007828:Laryngoscopy; D007902:Length of Stay; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography; D013528:Surgical Staplers; D013997:Time Factors; D016896:Treatment Outcome; D016672:Zenker Diverticulum / Q000000981:diagnostic imaging / Q000601:surgery*