Stapler failure in pharyngeal diverticulectomy: a suggested modification in surgical technique

The use of a mechanical stapling device during excision of a pharyngeal pouch is now becoming more common, and has many advantages including less contamination of the wound by pharyngeal contents and a shorter operating time. The manufacturers recommend dividing the neck of the pouch flush with the stapler before removing the stapler. We report a case where the stapler failed, leaving a larger defect in the pharyngeal wall necessitating a hand sutured closure. We recommend a change in practice: an artery forcep is applied across the pouch distal to the stapler, the stapler is then removed and the staple line inspected before dividing the pouch.