Microendoscopic Surgery of the Hypopharyngeal Diverticulum Using Electrocoagulation or Carbon Dioxide Laser

Abstract

In 1964 we started to treat hypopharyngeal (Zenker's) diverticular endoscopically, using the procedure described by Dohlman. With the increase in the number of patients (274 patients up until 1982), the technique and the instruments used have improved. This paper describes the technique we have used since 1981, which involves exposure of the tissue bridge between esophagus and diverticulum with the aid of a specially designed scope and subsequent severance of this bridge under microscopic control. In 12 cases the bridge was severed by electrocoagulation, while the CO2 laser was used for this purpose in another 12 cases. Both techniques have given good results. Essential advantages or disadvantages of either of these methods could not be elicited. We regard the use of an operating microscope as a great improvement.

Endoscopic stapling diverticulotomy for pharyngeal pouch

“…It is therefore difficult to draw a firm conclusion as to which,is the better method of treatment. Centres dedicated to performing endoscopic diverticulotomy as the first line treatment for pharyngeal pouch appear to have the best results and the smallest number of complications (3,6,7,15). We are of the opinion that it is the experience of the surgeon rather than the type of procedure which plays the most important role in the outcome of the procedure.…”

“…Endoscopic diverticulotomy was first described by Mosher (3)(4)(5) and the introduction of microlaryngoscopic laser division of the septum either with the CO2 laser (4,6,7) or the KTP/ 532 laser (8). Whichever technique is employed, the principle of the treatment remains the same, the aim being to divide the septum between the oesophagus and the Under general anaesthesia with endotracheal intubation and muscle relaxant, a Karl Storz Weerda distending diverticuloscope (Fig.…”

Current management in pharyngeal pouch surgery by UK otorhinolaryngologists

“…5 The endoscopic technique was popularised by Dohlman using a diathermy knife to divide the common septum. 6 This method has since been further modified to include the use of an operating microscope, 7 CO 2 laser, 7,8 KTP laser 9 and, more recently, an endoscopic stapling device. 10 Our aim was to establish current trends in the management of pharyngeal pouches by UK otolaryngologists.…”

Microendoscopic treatment of the hypopharyngeal diverticulum with the CO2 laser

“…Surgery was performed in all cases under general anesthesia. For optimal display of the tissue bridge, the Groningen diverticuloscope was used until 1988 [9], and afterwards the Weerda diverticuloscope [10]. By spreading the lips of the diverticuloscope, the muscular septum is tightened [ Fig.…”

“…In the 1930s, Seiffert [5] and Dohlman [6] independently used this method again, and during the following years it was modified and successfully optimized [7,8]. In 1981, van Overbeek [9] introduced microendoscopic surgery for hypopharyngeal diverticulum using the operating microscope and the CO 2 laser.…”