Jean-Michel Fabre

Abdominal laparoscopic approach for thoracic epiphrenic diverticulum

Abstract. The true incidence of epiphrenic esophageal diverticulum is unknown. Traditionally, diverticulectomy via a left thoracic approach has represented the gold standard. Trans-hiatal esophageal dissection under laparoscopy is feasible, but has not, to our knowledge, been applied before in the treatment of epiphrenic esophageal diverticulum.

Robotic Enucleation of an Esophageal Submucosal Tumor in the Prone Position

Background: Esophageal submucosal gastrointestinal stromal tumors (GISTs) are rare. Resection is indicated due to their malignant potential. Case Description: A 76-year-old woman complained of mild dysphagia. A submucosal tumor of the lower thoracic esophagus was found endoscopically. Computed tomography (CT) scan revealed a 40-mm anterolateral submucosal tumor. Endoscopic ultrasound revealed a hypoechoic and inhomogeneous lesion, developed from the fourth layer of the lower esophagus. In the prone position, the patient underwent robot-assisted right thoracoscopic enucleation of the esophageal submucosal tumor. The procedure was successfully completed with three trocars. No surgical complications occurred during the intervention or the postoperative stay. The patient was discharged on postoperative. Pathologic examination of the specimen revealed a GIST.