Endoscopic stapling of pharyngeal pouch: A 10‐year review of single versus multiple staple rows

Abstract

The technique of endoscopic pharyngeal pouch stapling has the potential to achieve excellent results. The application of more than one row of staples may be necessary to divide the common wall. However, in our series this is associated with a significantly increased risk of esophageal or pouch perforation. Care should be taken during the placement of multiple rows of staples.

Surgical Treatment of Zenker's Diverticulum

“…We identified 6,915 patients from 93 studies evaluating the effect of the surgical treatment for ZD, including 52 studies [8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59] (n = 3,336) on endoscopic surgeries, 22 [60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81] (n = 2,204) on open surgeries, and 19 [3,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,…”

“…For a very large diverticulum, to achieve a sufficient myotomy, a longer incision of the septum is always needed, in which case the sutureless techniques like laser, APC and diathermy may encounter a high chance of bleeding. The stapling technique therefore seems more suitable in this situation, but application of multiple staple rows as needed in a large diverticulum was associated with higher leak rate as well [45]. Counter et al [18] also considered a very large diverticulum as a contraindication for the endoscopic approach where the insertion of the stapler with a sufficient distance down the endoscope could be a limiting factor.…”

Endoscopic needle‐knife treatment for symptomatic esophageal Zenker’s diverticulum: A meta‐analysis and systematic review

“…Management of ZD has undergone a series of evolutionary changes . Open surgical techniques include diverticulectomy with or without cricopharyngeus myotomy, myotomy alone, and diverticulopexy with myotomy.…”

“…3,4 Management of ZD has undergone a series of evolutionary changes. [4][5][6][7][8] Open surgical techniques include diverticulectomy with or without cricopharyngeus myotomy, myotomy alone, and diverticulopexy with myotomy. Since an endoscopic stapler was introduced through a rigid scope, intraluminal approaches have tended to be superior to open-neck surgical approaches, with comparable success rates and less traumatic injury.…”

Optimising endoscopic stapling of pharyngeal pouches

“…3 Failure to engage the stapling device over a small cricopharyngeal bar has also been cited as a reason why endoscopic diverticulotomy is not suitable for small pouches. 3 Failure to engage the stapling device over a small cricopharyngeal bar has also been cited as a reason why endoscopic diverticulotomy is not suitable for small pouches.…”