{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:20:26Z","timestamp":1787772026766,"version":"build-2784847793"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Epiphrenic oesophageal diverticulum (ED) is a rare condition often associated with oesophageal motility disorders, most notably achalasia cardia. Symptoms include dysphagia, regurgitation, chest pain, halitosis and respiratory symptoms. Surgical management includes diverticulectomy, Heller\u2019s cardiomyotomy and partial fundoplication. While thoracic approaches were traditionally used, the laparoscopic transhiatal approach offers distinct advantages. We report the case of a 69-year-old female presenting with dysphagia, foul-smelling regurgitation and chest pain. Her Eckardt score was seven. Investigations revealed a large left-sided epiphrenic diverticulum, type 2 achalasia and a sliding hiatal hernia. She underwent laparoscopic transhiatal diverticulectomy using an endoscopic stapler, Heller\u2019s cardiomyotomy, crural repair and anterior Dor fundoplication. Intraoperative endoscopy was used to guide stapling, assess adequacy of the myotomy and check mucosal integrity. The surgery and post-operative course were uneventful. The patient was started on oral liquids on post-operative day 1 and was discharged on day 5. Follow-up at 1 and 3 months revealed complete resolution of symptoms with Eckardt scores of 2 and 0, respectively. No post-operative complications were observed during the 5-month follow-up. Diverticulectomy using an endostapler, Heller\u2019s cardiomyotomy and Dor\u2019s fundoplication, performed through a laparoscopic transhiatal approach with intraoperative upper gastrointestinal endoscopy monitoring, is a safe and effective method of treating symptomatic ED.<\/jats:p>","DOI":"10.4103\/jmas.jmas_375_25","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T13:01:44Z","timestamp":1772110904000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Large epiphrenic oesophageal diverticulum with hiatus hernia: Excellent outcome with laparoscopic transhiatal approach"],"prefix":"10.4103","author":[{"given":"Ruchir H.","family":"Jhaveri","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal, Bariatric and Minimal Access Surgery, Kiran Multi Super Speciality Hospital, Surat, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dharmesh S.","family":"Dhanani","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal, Bariatric and Minimal Access Surgery, Kiran Multi Super Speciality Hospital, Surat, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chintan B.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal, Bariatric and Minimal Access Surgery, Kiran Multi Super Speciality Hospital, Surat, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikash T.","family":"Tiwari","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal, Bariatric and Minimal Access Surgery, Kiran Multi Super Speciality Hospital, Surat, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"R1-20260226","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1097\/00000658-200203000-00006","article-title":"Physiologic basis for the treatment of epiphrenic diverticulum","volume":"235","author":"Nehra","year":"2002","journal-title":"Ann Surg"},{"key":"R2-20260226","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1308\/rcsann.2019.0007","article-title":"The laparoscopic approach for epiphrenic diverticula with achalasia","volume":"101","author":"Mandovra","year":"2019","journal-title":"Ann R Coll Surg Engl"},{"key":"R4-20260226","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1007\/s00268-011-1065-z","article-title":"Therapeutic strategies for epiphrenic diverticula:Systematic review","volume":"35","author":"Zaninotto","year":"2011","journal-title":"World J 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Tech"},{"key":"R9-20260226","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1007\/s12328-023-01765-2","article-title":"Optimal surgical approaches for esophageal epiphrenic diverticulum:Literature review and our experience","volume":"16","author":"Sato","year":"2023","journal-title":"Clin J Gastroenterol"},{"key":"R10-20260226","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1007\/s11605-017-3368-3","article-title":"Systematic review and meta-analysis of surgical treatment of non-Zenker's oesophageal diverticula","volume":"21","author":"Chan","year":"2017","journal-title":"J Gastrointest Surg"},{"key":"R11-20260226","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1097\/01.sla.0000136940.32255.51","article-title":"Heller myotomy versus Heller myotomy with Dor fundoplication for achalasia:A prospective randomized double-blind clinical trial","volume":"240","author":"Richards","year":"2004","journal-title":"Ann Surg"},{"key":"R12-20260226","doi-asserted-by":"crossref","first-page":"784","DOI":"10.4081\/cp.2015.784","article-title":"Large epiphrenic diverticula:A rare case presentation","volume":"5","author":"Bhandarwar","year":"2015","journal-title":"Clin Pract"},{"key":"R13-20260226","doi-asserted-by":"crossref","first-page":"2076","DOI":"10.1016\/j.athoracsur.2005.06.007","article-title":"Minimally invasive operation for esophageal diverticula","volume":"80","author":"Fernando","year":"2005","journal-title":"Ann Thorac Surg"},{"key":"R14-20260226","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1097\/MCG.0000000000001622","article-title":"Peroral endoscopic myotomy for the treatment of esophageal diverticula:A systematic review and meta-analysis","volume":"56","author":"Facciorusso","year":"2022","journal-title":"J Clin Gastroenterol"}],"container-title":["Journal of Minimal Access 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