ABSTRACT
Esophageal diverticula are uncommon and typically cause dysphagia, regurgitation, recurrent aspiration, or chest pain. Most clinically relevant esophageal diverticula are of the "pulsion" variety and result from an underlying esophageal motility disorder, most commonly achalasia. Traditional surgical treatment of esophageal diverticula has been the so-called triple-treat operation, consisting of diverticulectomy, esophageal myotomy, and partial fundoplication performed by an open left thoracotomy. The patient should be considered high risk for aspiration during induction of general anesthesia and intubation due to the presence of the diverticulum, the underlying esophageal motility disorder, and possible reflux that may have resulted from a prior myotomy. A complete diverticular resection and closure is imperative without compromising the esophageal lumen. A pleural drainage catheter is routinely advanced via one of the trocar incisions, positioned near the diverticulectomy without abutting it, and left in place until an oral diet is resumed.
