Endoluminal Functional Imaging Demonstrates Need for Myotomy During Epiphrenic Diverticulectomy

Epiphrenic diverticulum develops when elevated esophageal intraluminal pressure causes herniation of the mucosa and submucosa through an area of weakness in the muscularis layer. Treatment must address both the diverticulum and the underlying esophageal dysmotility. The endoluminal functional lumen imaging probe allows measurement of the lower esophageal sphincter pressures to achieve the ideal lower esophageal sphincter distensibility that prevents postoperative gastroesophageal reflux disease as well as diverticulum recurrence. We present the case of a 60-year-old woman with an epiphrenic diverticulum who underwent robot-assisted laparoscopic diverticulectomy with Heller myotomy and Dor fundoplication. The endoluminal functional lumen imaging probe was used for intraoperative monitoring.