A robotic-assisted approach is safe and effective for repairing giant epiphrenic diverticulum

Epiphrenic esophageal diverticulum is a rare disorder accounting for <10% of all esophageal diverticula. Surgical treatment may be necessary for larger diverticula causing significant symptoms. In this technical note, we describe a robotic-assisted approach to repair of a giant epiphrenic diverticulum. A 53-year-old female presented to the Department of Surgery, University of Colorado in January 2020 with a long-standing history of dysphagia and regurgitation associated with halitosis. Following a thorough preoperative workup, the patient underwent a robotic-assisted transhiatal approach with resection of the diverticulum followed by complete myotomy and Dor fundoplication. The patient had no perioperative complications and demonstrated complete relief of symptoms at the 6-month follow-up. A robotic-assisted transhiatal approach is a safe and effective technique for the resection of large epiphrenic diverticula. Complete myotomy followed by an antireflux procedure is critical to reducing perioperative complications and maintaining long-term symptom relief. Further prospective studies are needed to evaluate the specific morbidity risks associated with this approach.