Laparoscopic transhiatal approach for resection of midesophageal diverticula

Resection of symptomatic midesophageal diverticula is traditionally performed with a thoracic approach, occasionally requiring additional laparoscopic surgery for management of associated pathologies, such as esophageal dysmotility and hiatus hernia. We present the resection of large midesophageal pulsion diverticula using a single laparoscopic transhiatal approach. Bariatric instrumentation was used to obtain extra intraoperative length, and concurrent on-table endoscopy was performed to ensure complete mucosal seal. The patient was discharged home on day 19 and remains well 12 months after surgery. Laparoscopic transhiatal resection of symptomatic midesophageal diverticula may be a safe alternative to the traditional thoracic or thoracoabdominal technique.