Journal de Chirurgie Viscérale – Vol. – N° 4 – p. – Diverticulopexie pour diverticule de Zenker – EM|consulte. A Zenker’s diverticulum, also pharyngoesophageal diverticulum, also pharyngeal pouch, also hypopharyngeal diverticulum, is a diverticulum of the mucosa of. Keywords: Zenker, esophageal diverticulum, diverticulectomy, .. M. Diverticule pharyngo- oesophagien de zenker a propos de cinq cas.
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Minimally invasive surgery for Zenker diverticulum: CO2 laser versus endoscopic stapling”. In other projects Wikimedia Commons. Our study group is made up of 11 patients with surgical indication for Zenker diverticulum, operated between and Nowadays, therapeutic management of Zenker diverticulum implies 2 objectives, each one with specific technical details: This video demonstrates a robotic-assisted Heller procedure for treatment of esophageal achalasia.
Esophageal manometry must be included in the investigations of these patients, on one hand for the assessment of dysphagia and on the other hand for optimization of indication and surgical technique. Not to be confused with Pharyngeal pouch embryology. Journal List J Diverticu,e Life v.
Once the myotomy is completed a standard Dor Fundoplication is performed. Top of the page – Article Outline. In the second operation, it was found that there was an incomplete myotomy, the correction of the myotomy leading to the healing of the leak zehker 20 ]. It was named in by German pathologist Friedrich Albert von Zenker.
Iconography : Diverticulopexie pour diverticule de Zenker – EM|consulte
Open in a separate window. Sincewhen Ludlow had made the first description of the surgical treatment that was reported by Weeler indifferent therapies for Zenker diverticulum were imagined. You may thus request that your data, should it be inaccurate, incomplete, unclear, outdated, not be used or stored, be corrected, clarified, updated or deleted. Laparoscopic transhiatal esophagectomy with Akiyama tube reconstruction for a terminal achalasia.
Surg Clin North Am. The change in direction of the muscular fibers, from circular at the esophagus, to oblique at the stomach, makes it difficult to develop the necessary submucosal plane for dividing the muscular fibers. Thoracoscopic esophageal diverticulectomy and myotomy.
We have routinely performed esophageal myotomy, distal to the diverticular opening, regardless of the manometry findings or the intraoperative aspect of the muscular layer.
It has an incidence of 2 perper year in the UK, but there is significant geographical variation around the world.
However, in recent times non-surgical endoscopic techniques have gained more importance as they allow for much faster recoveryand the currently preferred treatment is endoscopic stapling   i. The degeneration of the striate muscular fibers of crico-pharyngeal muscle was seen at the histological examination; which are gradually replaced by fibro-fatty tissue [ 34 ].
The different incidence related to race or geographic area and the communicated familial cases may suggest the implication of a genetic mechanism. Belsey Functional disease of the esophagus. Idiopathic achalasia is the most frequent esophageal motility disorder. The patient had previously undergone neoadjuvant chemoradiotherapy with poor results. Persistent pharyngeocutaneous fistula after transcervical resection of a diverticulum of the hypopharynx.
Other non-surgical treatment modalities also exist, such as endoscopic laser, which recent evidence suggests is less effective than stapling. She complained of epigastric pain and dysphagia. The authors present a case of a laparoscopic transhiatal esophagectomy with Akiyama tube reconstruction in a woman with long-term achalasia and megaesophagus.
Regarding the surgical indication, it is not yet well established, some authors state that the presence of the diverticular pouch is already a surgical indication, others establish the indication adapted to the case, according to zenoer, age, associated pathology and the presence of complications, attitude that we agree with.
This procedure does not require the opening of the esophageal mucosa, reducing the risk of developing fistula or stenosis, but includes myotomy. This has to be done carefully, to the level of diverticyle, regardless of the macroscopic look, often normal, of the muscular layer. If you want to subscribe to this journal, see our rates You can purchase this item in Diverticcule Per View: Its accessibility and safety guarantee wide clinical utilization in patients with suspected benign and malignant diseases of the esophagus.
Zenker’s diverticulum – Wikipedia
The patients with Zenker diverticulum frequently associate hiatal hernia. The technical key steps of the surgical procedure are presented in a step by step way: Discussion Sincewhen Ludlow had made the first description of the surgical treatment that diverrticule reported by Weeler indifferent therapies for Zenker diverticulum were imagined.
R VaillancourtA Duranceau. Access to the PDF text.
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The hypo pharynx is exposed using bivalve Weerda laryngoscope, which is positioned behind the endo-tracheal tube, by using an upper digestive endoscope, so that the two blades enter one in the esophageal lumen and the other in the diverticular pouch, exposing the separating septum. Introduction Zenker diverticulum is the most common proof of a primitive pharyngo-esophageal motility disorder.
The advantages compared with classic surgery are the absence of scar, diminished postoperative pain, early reestablishing of oral feeding and reduced length of hospital stay [ 24 ]. The diagnosis was based on a clinical picture severe dysphagia, regurgitations, weight loss and investigations barium passage, upper endoscopy.
The myotomy is started just above the gastroesophageal junction and extended 6 cm proximally zenkee 2 cm distally onto the stomach using robotic articulated scissors.