Combined Prone Thoracoscopy and Supine Laparoscopy for treatment of an Epiphrenic Diverticulum

The laparoscopic treatment of epiphrenic diverticula via a totally abdominal approach has been well described. One of the challenges of the laparoscopic approach to the treatment of large epiphrenic diverticula has been safe and adequate proximal dissection. Thoracoscopy provides another means of accessing the mid to distal esophagus, while addition of this modality allows for full visualization of the proximal extent of large diverticula. One of the challenges of traditional thoracoscopy is the difficulty of achieving adequate visualization around the structures of the chest. The advent of prone thoracoscopy addresses this issue by allowing the lung to fall to the anterior chest wall allowing for full visualization of the entire esophagus within the mediastinum with minimal obstruction. Our video submission offers an example of our early experience with prone thoracoscopy in the treatment of a 7.3 cm epiphrenic diverticulum. This offers an example of the excellent visualization of large diverticula within the chest afforded by prone positioning, as well as serving as evidence of the feasibility of this approach.

Session: Podium Presentation

Program Number: V023

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