Robotic Surgery: An Effective Treatment Option for Epiphrenic Diverticulum Associated with Nutcracker Esophagus
- 1 Department of Digestive Surgery, Hospital São José do Avaí, Itaperuna, Brazil
- 2 Department of Digestive Surgery, Hospital São José do Avaí, Itaperuna, Brazil
- 3 Department of Digestive Surgery, Hospital São José do Avaí, Itaperuna, Brazil
- 4 Department of Digestive Surgery, Hospital São José do Avaí, Itaperuna, Brazil
Abstract
Background: Epiphrenic Diverticulum is frequently associated with esopha geal motility disorders, such as nutcrackers esophagus. The diagnosis is usual ly made using imaging studies such as a Barium esophagogram, and esophageal manometry. Surgical treatment options for epiphrenic diverticulum and EN include diverticulectomy and wide myotomy. Aim: The resection of three epiphre nic diverticula and extensive myotomy were performed by robotic thoracoscopy uneventfully. Case presentation: A 65-year-old female complaining of dysphagia for solid foods, Chest pain and regurgitation. Esophagogastro duodenoscopy (EDG) with difficulty in advancing the endoscope at 25 cm and demonstrating an ED, no hiatal hernia and normal stomach and duodenum. Barium Esophagogram showed multiple diverticula and tortuosity throughout the esophagus. Conclusion: With robotic surgery, surgeons can perform highly precise operations with enhanced 3D vision and control. Through this cutting-edge approach, the treatment of ED associated with EN can be drastically changed, promising better outcomes for patients.
- Matsumoto, H., Kubota, H., Higashida, M., et al. (2015) Esophageal Epiphrenic Diverticulum Associated with Diffuse Esophageal Spasm. International Journal of Surgery Case Reports, 13, 79-83. https://doi.org/10.1016/j.ijscr.2015.06.018
- Burmeister, S. (2013) Review of Current Diagnosis and Management of Diffuse Esophageal Spasm, Nutcracker Esophagus/Spastic Nutcracker and Hypertensive Lower Esophageal Sphincter. Current Opinion in Otolaryngology & Head and Neck Surgery, 21, 543-547. https://doi.org/10.1097/MOO.0000000000000002
- Yam, J., Baldwin, D. and Ahmad, S.A. (2023) Esophageal Diverticula. StatPearls, Treasure Island, FL.
- Soares, R., Herbella, F.A., Prachand, V.N., et al. (2010) Epiphrenic Diverticulum of the Esophagus. From Pathophysiology to Treatment. Journal of Gastrointestinal Surgery, 14, 2009-2015. https://doi.org/10.1007/s11605-010-1216-9
- Rice, T.W., Goldblum, J.R., Yearsley, M.M., et al. (2009) Myenteric Plexus Abnormalities Associated with Epiphrenic Diverticula. European Journal of Cardio-Thoracic Surgery, 35, 22-27. https://doi.org/10.1016/j.ejcts.2008.09.025
- Carlson, D.A., Ravi, K., Kahrilas, P.J., et al. (2015) Diagnosis of Esophageal Motility Disorders: Esophageal Pressure Topography vs. Conventional Line Tracing. American Journal of Gastroenterology, 110, 967-977. https://doi.org/10.1038/ajg.2015.159
- Alecu, L., Bărbulescu, M., Ursuţ, B., et al. (2015) Large Oesophageal Epiphrenic Diverticulum Resected by Transhiatal Robotic-Assisted Approach—Case Report. Chirurgia (Bucur), 110, 72-77.
- Hukkeri, V.S., Jindal, S., Qaleem, M., et al. (2016) Robotic Transhiatal Excision of Epiphrenic Diverticula. Journal of Robotic Surgery, 10, 365-368. https://doi.org/10.1007/s11701-016-0595-7
- Thomas, M.L., Anthony, A.A., Fosh, B.G., et al. (2001) Oesophageal Diverticula. British Journal of Surgery, 88, 629-642. https://doi.org/10.1046/j.1365-2168.2001.01733.x
- Goel, S. and Nookala, V. (2023) Diffuse Esophageal Spasm. StatPearls, Treasure Island, FL.
- Taniguchi, Y., Takahashi, T., Nakajima, K., et al. (2017) Multiple Huge Epiphrenic Esophageal Diverticula with Motility Disease Treated with Video-Assisted Thoracoscopic and Hand-Assisted Laparoscopic Esophagectomy: A Case Report. Surgical Case Reports, 3, Article No. 63. https://doi.org/10.1186/s40792-017-0339-6
- Zaninotto, G., Portale, G., Costantini, M., et al. (2011) Therapeutic strategies for epiphrenic diverticula: systematic review. World Journal of Surgery, 35, 1447-1453. https://doi.org/10.1007/s00268-011-1065-z