ABSTRACT
Esophageal epiphrenic diverticula are pulsion diverticula located in the distal 10 cm of the esophagus. They represent the protrusion of the mucosa and submucosa through the muscular layers of the esophageal wall. A large number of patients with epiphrenic diverticula are asymptomatic and the diverticulum is found incidentally as part of a work-up for other reasons. All patients with esophageal epiphrenic diverticula should be evaluated with the same diagnostic imaging and physiologic studies as any patient with any other gastroesophageal pathology. The patient is positioned on the operative table, pneumatic compression stockings are used for deep vein thrombosis prophylaxis, and preoperative antibiotics are used prior to skin incision. The patients are usually admitted to the surgical ward overnight and water-soluble contrast esophagography is performed on postoperative day 1 to evaluate for leaks. Laparoscopic transhiatal surgery for esophageal epiphrenic diverticula has been proven feasible and safe in experienced hands.
