title: Laproendoscopic single site oesophageal diverticulectomy.
abstract: Epiphrenic divericula are uncommon disorders of the lower oesophagus, which are symptomatic in only 15-20% of cases. The optimum treatment modality for such cases remains an oesophageal diverticulectomy with long myotomy with or without an antireflux operation. Recently, this is increasingly being done through the laparoscopic approach. Here we describe the first reported case of oesophageal diverticulectomy through the laparoendoscopic single site approach. A 57-year-old man presented to us with 6 months history of dysphagia and regurgitation. Patient was investigated with upper gastrointestinal (UGI) endoscopy, barium swallow, CECT chest and abdomen, oesophageal manometry and 24 hour pH study. He was diagnosed to have lower oesophageal diverticulum with mildly elevated pressure readings in manometric studies with normal peristalsis. Based on his symptoms, he was taken up for surgery. A laparoscopic transhiatal oesophageal diverticulectomy with myotomy was done through laparoendoscopic single site technique. The procedure lasted 160 min. There was no intraoperative complication. Gastrograffin study was done on postoperative day 2 following which he was started on liquids. He made an uneventful recovery and was discharged on fourth day. He remained asymptomatic on follow up. Oesophageal diverticulectomy is possible through laparoendoscopic single site approach if necessary expertise is available.
authors.affiliation: Department of GI Surgery, GEM Hospital, Coimbatore, Tamil Nadu, India.
authors.forename: Chinnusamy
authors.initials: C
authors.lastname: Palanivelu
authors.forename: Anirudh
authors.initials: A
authors.lastname: Vij
authors.forename: Subbiya
authors.initials: S
authors.lastname: Rajapandian
authors.forename: Senthilnathan
authors.initials: S
authors.lastname: Palanisamy
authors.forename: Jasmeet S
authors.initials: JS
authors.lastname: Ahluwalliah
authors.forename: Praveenraj
authors.initials: P
authors.lastname: Palanivelu
keywords: Epiphrenic diverticulum; LESS; laparoscopic oesophageal surgery; oesophageal diverticulectomy; single incision laparoscopy
references.citation: Ann Thorac Surg. 2005 Dec;80(6):2076-80
references.pmid: 16305847
references.citation: Ann Thorac Surg. 1993 May;55(5):1109-13; discussion 1114
references.pmid: 8494418
references.citation: Surg Endosc. 2011 Sep;25(9):3008-15
references.pmid: 21487878
references.citation: Ann Surg. 1998 Feb;227(2):174-8
references.pmid: 9488513
references.citation: Surg Gynecol Obstet. 1980 Nov;151(5):593-600
references.pmid: 6776641
references.citation: Semin Thorac Cardiovasc Surg. 1999 Oct;11(4):358-62
references.pmid: 10535377
references.citation: Dis Esophagus. 2008;21(2):176-80
references.pmid: 18269655
references.citation: JSLS. 2009 Jul-Sep;13(3):346-9
references.pmid: 19793475