Minimally Invasive Approach to Epiphrenic Oesophageal Diverticulum: A Case Report

Abstract

An oesophageal diverticulum is a relatively rare disorder of the oesophagus which results in the outpouching of the oesophageal mucosa through a weak portion within the oesophageal lining. Oesophageal diverticula occur in <1% of the population and are found in approximately 1-3% of those presenting with dysphagia. A 75-year-old male patient came to the surgical Outpatient Department (OPD) with chief complaints of difficulty in swallowing for 2-3 months, initially with solids which later progressed to difficulty in swallowing liquids. He was diagnosed on a Contrast-Enhanced Computed Tomography (CECT) scan with a large oesophageal diverticulum arising from the right lower lateral thoracic oesophagus just proximal to the oesophagogastric junction in the retrocardiac region with no filling defect or mucosal thickening. The patient was treated with transhiatal laparoscopic oesophageal diverticulectomy with cardiomyotomy and Dor fundoplication. For symptomatic patients, most often, minimally invasive myotomy and removal of the pouch endoscopically are advised, which may pose a surgical challenge due to the rarity of the disease.

Keywords

• laparoscopy
• minimal access
• oesophagus