The laparoscopic transhiatal approach gives a satisfactory access to the lower mediastinal esophagus. This allows to treat epiphrenic diverticula of the esophagus with a diverticulectomy combined with esophageal myotomy and an antireflux procedure. The operation is performed under a constant esopghagoscopic control. Seven patients underwent this procedure from January 1994 through December 1998 after a thorough pathophysiologic study: no complications were observed and the results are satisfactory. The principle of treatment of the diverticular pouch and the underlying motor disorder is respected with this procedure.