Treatment of esophageal diverticula in uniportal video-assisted thoracoscopic surgery

Esophageal diverticulum is a rare disease caused by impaired esophageal motility. It may present with disorders like pain, heartburn, dysphagia, episodes of food regurgitation and halitosis, but often the patients are asymptomatic. Diagnosis is based on the esophagogram with barite meal, gastroscopy and esophageal manometry. The diverticula can be classified according to the site of onset in the esophagus: diverticula of the distal third (epiphrenic, 20%), mediothoracic or mediastinal (10%) and proximal diverticula (Zenker diverticula, 70%). Traditionally, surgical treatment involves a thoracotomy approach that allows diverticulectomy and esophageal myotomy. In our centre, we started to use the uniportal video-assisted thoracoscopic surgery (VATS) approach for the treatment of esophageal diseases, both neoplastic and benign. In our preliminary experience with uniportal VATS diverticulectomy, we obtained good results in terms of effectiveness, reduction in hospitalization time, complications, pain control and early recovery of patient’s daily activities.