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UNUSUAL CASE
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A complex modality of achalasia, diverticulum and paraesophageal hernia treated through three-dimensional left thoracoscopy


 First Department of Surgery, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece

Correspondence Address:
Eustratia Mpaili,
Department of Surgery, Laiko General Hospital, National and Kapodistrian University of Athens, Agiou Thoma 17, Athens 11527
Greece
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmas.JMAS_23_20

Herein, we report a case of a patient with recurrent dysphagia after an open transabdominal hernia repair for a Type IV paraesophageal hernia performed elsewhere. Subsequent work-up and medical records' review revealed the coexistence of a large left epiphrenic diverticulum in combination with achalasia synchronous to the recently repaired paraesophageal hernia. A three-dimensional left thoracoscopic diverticulectomy with a long esophagomyotomy was conducted under endoscopic guidance intraoperatively, with no perioperative complications. At 12 months' follow-up evaluation, the patient presents well with no documented recurrence. Cumulative experience from various medical specialties regarding esophageal motility disorders and endoscopic state-of-the-art techniques, when combined with minimally invasive surgical techniques, provide an effective management of esophageal motility syndromes, overall.


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    -  Mpaili E
    -  Meropouli A
    -  Mpoura M
    -  Vagios I
    -  Davakis S
    -  Liakakos T
    -  Charalabopoulos A
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2004 Journal of Minimal Access Surgery
Published by Wolters Kluwer - Medknow
Online since 15th August '04