Endoluminal Functional Imaging Demonstrates Need for Myotomy During Epiphrenic Diverticulectomy.

Area of Science:

• Gastroenterology and Surgical Innovation

Background:

• Epiphrenic diverticulum results from elevated intraluminal pressure causing mucosal herniation through muscularis weakness.
• Effective treatment necessitates addressing both the diverticulum and associated esophageal dysmotility.

Observation:

• A 60-year-old woman with epiphrenic diverticulum underwent robot-assisted laparoscopic diverticulectomy, Heller myotomy, and Dor fundoplication.
• The endoluminal functional lumen imaging probe was utilized for intraoperative monitoring during the procedure.

Findings:

• The endoluminal functional lumen imaging probe enables precise measurement of lower esophageal sphincter pressures.
• Optimizing lower esophageal sphincter distensibility intraoperatively can prevent postoperative gastroesophageal reflux disease and diverticulum recurrence.

Implications:

• This case highlights the utility of the endoluminal functional lumen imaging probe in guiding surgical management of epiphrenic diverticulum.
• Intraoperative use of this technology may improve patient outcomes by ensuring optimal esophageal function post-surgery.