Open staple diverticulectomy for a large recurrent Zenker's diverticulum: Still a valid procedure

Andy M. Courson, April M. Landry, David G. Lott, Michael L. Hinni

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Objectives: We demonstrate indications for external mechanical stapler diverticulectomy in the modern era of endoscopic treatment. We review treatment of a large diverticulum and discuss considerations that should be made in deciding on the type of surgical treatment. Methods: The index case was in a 75-year-old man who had undergone open cricopharyngeal myotomy with diverticulopexy 35 years earlier. He presented with 25 years of recurrent symptoms. A swallow study showed a 6.5 x 5.0-cm diverticulum. The diverticulum was deemed too large for standard endoscopic myotomy, so diverticulectomy was performed with a stapler. Results: The patient was discharged on postoperative day 3 without complications. A swallow study on postoperative day 5 demonstrated no diverticulum or extravasation of barium. The patient resumed a normal diet with resolution of dysphagia. Two additional patients with large Zenker's diverticula that were managed similarly are also discussed. Conclusions: Although endoscopic laser cricopharyngeal myotomy and stapler diverticulostomy have become standard treatments for Zenker's diverticulum, this case of a large recurrent diverticulum illustrates a situation in which older techniques may be preferred. Use of the mechanical stapler allowed for a shorter surgery time than traditional suture techniques, and the potential for an earlier return to a normal diet.

Original languageEnglish (US)
Pages (from-to)729-733
Number of pages5
JournalAnnals of Otology, Rhinology and Laryngology
Volume122
Issue number12
DOIs
StatePublished - Dec 2013

Keywords

  • Operative procedure
  • Surgical stapler
  • Zenker's diverticulum

ASJC Scopus subject areas

  • Otorhinolaryngology

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