Surgical treatment of symptomatic esophageal epiphrenic diverticuli previously required invasive thoracotomy with inherent risks and morbidities, especially problematic in patients of advanced age. Our video case report demonstratesa safe, laparoscopic approach to this problem.

Our patient is a 68 year old male with a 50 year history of baseline dysphagia, worsening over the last year. Preoperative work-up with EGD, UGI, Chest/Abdomen CT and esophageal manometry demonstrated a large epiphrenic diverticulum in the distal esophagus.

Laparoscopic, transhiatal resection of the epiphrenic diverticulum with long esophageal myotomy was completed in 278 minutes. A total of 6 trocars were used. EBL was 150mls. The only complication was a small left sided pneumothorax followed to resolution. A scheduled UGI on POD#1 demonstrated no leak. The patient was advanced to liquids on POD#3 and discharged home on POD#6 tolerating a soft diet. 3 weeks post-op the patient returned to unrestricted activity and diet with complete resolution of his dysphagia.

Laparoscopic approach to epiphrenic diverticuli allows for superior exposureto anatomy while providing the inherent benefits of decreased morbidity and recovery times associated with minimally invasive surgery.