[Laparoscopic transhiatal resection of epiphrenic diverticulum of the esophagus].

The operation of the epiphrenic diverticulum of the esophagus--due to its anatomical position--is feasible either with thoracotomy or with laparotomy. The advantages of the first method are the possibility of better exploration and a technically easier operation. At the same time, the disadvantage of the surgical procedure imposed on the patient by opening his/her thoracic cavity is not to be underestimated, either. In case of an abdominal approach, the diverticulum in the mediastinum causes difficulties. The laparoscopic method combines the advantages of both solutions. The authors report the case of a 62 years old woman with a history of regurgitation and swallowing problems accompanied by a 20-kilogram weight loss. Barium esophagography and esophagogastroduodenoscopy showed a typically positioned 11-cm large epiphrenic diverticulum. As an operative solution transhiatal laparoscopic resection of the diverticulum with Heller cardiomyotomy and Dor fundoplication using an endoscopic stapler was performed. The postoperative period was uneventful; the patient was discharged on the 8th post-operative day with unhindered swallow. In the international literature 79 cases treated with minimally invasive therapy have been published so far. Based on own experience, the authors state that the laparoscopic transhiatal resection of the epiphrenic diverticulum of the esophagus is successful and might be the method of choice.