Epiphrenic Diverticulum Excision by Laparoscopic Transhiatal Approach – A Case Report

Abstract

Epiphrenic diverticulum is a rare type of pulsion diverticulum that develops in the lower third of the oesophagus due to increased intra-oesophageal pressure. Patients often present with symptoms such as dysphagia, retrosternal discomfort, and recurrent vomiting or regurgitation of food. Surgery is considered the most effective treatment that addresses both the high intra-oesophageal pressure and the diverticulum itself. Traditionally, this procedure was performed via thoracotomy, which involved significant morbidity. However, recent advances in minimally invasive techniques, have led to a shift from a thoracoscopic to a laparoscopic approach for treating majority of these diverticula. We present a case of a 75-year-old male who was initially misdiagnosed with a sliding hiatus hernia. He underwent hiatus repair and fundoplication, but his symptoms persisted, prompting further evaluation, which revealed an epiphrenic diverticulum. The previous surgical intervention was reversed, and a laparoscopic excision of the epiphrenic diverticulum with cardiomyotomy and anterior fundoplication was done. The patient recovered well postoperatively and was able to eat without any difficulty