초록접수 현황
| 17F-256 | Video session발표 |
Laparoscopic Surgery for Epiphrenic Esophageal Diverticulum
Yeon Soo Kim¹, Woo Yong Lee²
¹Department of Thoracic and Cardiovascular Surgery, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Gyeonggi-do, Republic of Korea., ²Department of General Surgery, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Gyeonggi-do, Republic of Korea
Purpose : The Epiphrenic esophageal diverticula are relatively rare pulsion pseudodiverticula, usually involving the distal 10cm esophagus. We report a case of the minimal invasive laparoscopic surgery of it.
Methods : We present 73 year-old man who admitted with regurgitation and dysphagia. Esophagogastroscopy demonstrated esophageal diverticulum packed with foreign material. Esophagogram demonstrated epiphrenic diverticulum. The patient was positioned in a modified lithotomy position. We used two 12mm and three 5mm trocars. Esophagus was separated completely from the diaphragm. Mobilization of the esophagus was continued through the hiatus into the mediastinum where the diverticulum was identified. The diverticulum was resected using endo GIA. The separated esophageal muscle was reapproximated with continuous suture. The myotomy of esophagus was performed away from the diverticulum staple line. Myotomy was performed from the upper level of diverticulum to 2cm below the esophagogastric junction. Finally a Dor anterior partial fundoplication was performed.
Results : The operation time was 4 hours. There were no problems on esophagogram performed the 5th postoperative day.
Conclusion : The laparoscopic approach to this problem is safe, effective. So it should be considered as the surgical choice, even technically challenging.
Methods : We present 73 year-old man who admitted with regurgitation and dysphagia. Esophagogastroscopy demonstrated esophageal diverticulum packed with foreign material. Esophagogram demonstrated epiphrenic diverticulum. The patient was positioned in a modified lithotomy position. We used two 12mm and three 5mm trocars. Esophagus was separated completely from the diaphragm. Mobilization of the esophagus was continued through the hiatus into the mediastinum where the diverticulum was identified. The diverticulum was resected using endo GIA. The separated esophageal muscle was reapproximated with continuous suture. The myotomy of esophagus was performed away from the diverticulum staple line. Myotomy was performed from the upper level of diverticulum to 2cm below the esophagogastric junction. Finally a Dor anterior partial fundoplication was performed.
Results : The operation time was 4 hours. There were no problems on esophagogram performed the 5th postoperative day.
Conclusion : The laparoscopic approach to this problem is safe, effective. So it should be considered as the surgical choice, even technically challenging.
책임저자: Yeon Soo Kim
Department of Thoracic and Cardiovascular Surgery, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Gyeonggi-do, Republic of Korea
발표자: Yeon Soo Kim, E-mail : Kimyns@paik.ac.kr