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Updated: Nov 10, 2025

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function

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Published on: April 17, 2020

Right-sided Zenker's diverticulum resected using intraoperative neuromonitoring.

Yuta Sato¹, Yoshihiro Tanaka², Junichi Mase¹

¹Department of Surgical Oncology, Gifu University School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan.

Clinical Journal of Gastroenterology

|April 5, 2021

Summary

This study highlights the safe resection of a rare right-sided Zenker's diverticulum using intraoperative neuromonitoring to prevent recurrent laryngeal nerve injury. This technique aids in identifying nerve variations during surgery.

Keywords:

Intraoperative neuromonitoring Pharyngoesophageal diverticulum Recurrent laryngeal nerve Zenker’s diverticulum

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Area of Science:

Gastroenterology
Otolaryngology
Surgical Neurology

Background:

Right-sided Zenker's diverticulum is a rare condition.
Transcervical diverticulectomy carries a high risk of recurrent laryngeal nerve injury due to anatomical variations.

Observation:

A 55-year-old male presented with chronic cough and regurgitation.
Diagnosis was right-sided Zenker's diverticulum requiring open transcervical diverticulectomy and cricopharyngeal myotomy.

Findings:

Intraoperative neuromonitoring successfully identified the right recurrent laryngeal nerve's location.
The nerve's position was confirmed via intermittent stimulation during dissection, preventing injury.

Implications:

Intraoperative neuromonitoring is a beneficial tool for transcervical diverticulectomy of right-sided Zenker's diverticulum.
This technique can mitigate the risk of vocal cord paralysis by avoiding recurrent laryngeal nerve damage.