TY - CHAP M1 - Book, Section TI - Epiphrenic Diverticulectomy with Myotomy and Fundoplication A1 - Hunter, John G. A1 - Spight, Donn H. A1 - Sandone, Corinne A1 - Fairman, Jennifer E. Y1 - 2018 N1 - T2 - Atlas of Minimally Invasive Surgical Operations AB - Epiphrenic diverticula usually protrude from the right wall of the esophagus just above the gastroesophageal (GE) junction (Figure 1). They are usually associated with esophageal motility disorders, either diffuse esophageal spasm or achalasia. Even when preoperative esophageal motility does not detect a hypertensive nonrelaxing lower esophageal sphincter (LES), the treatment of choice for these lesions includes esophageal myotomy and diverticulectomy. Small, low-lying epiphrenic diverticula can be managed from the abdomen through the diaphragmatic hiatus. Large-mouth diverticula (greater than 3 cm) and those more than 3 cm above the hiatus should be approached through a right thoracoscopic approach as described in chapter 12. The chronically inflamed tissue often found adjacent to a diverticulum and the limited exposure of the mediastinum through an abdominal approach makes the transdiaphragmatic approach to large diverticula technically difficult and more hazardous than is necessary. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/23 UR - accesssurgery.mhmedical.com/content.aspx?aid=1162530076 ER -