Diverticulotomía endoscópica utilizando Ligasure™ / Endoscopic diverticulotomy using Ligasure™

INTRODUCCIÓN: El tratamiento endoscópico del divertículo de Zenker es considerado viable, efectivo y seguro. La utilización de la técnica sellado-sección mediante Ligasure™ proporciona una adecuada y rápida disección del tejido, logrando una hemostasia efectiva. PACIENTES Y MÉTODOS: Estudio retrospectivo, descriptivo, de todos los pacientes con divertículo de Zenker que fueron tratados a través de una diverticulotomía endoscópica utilizando el Ligasure ™. El procedimiento se realizó en la unidad de endoscopias, bajo sedación profunda controlada por el endoscopista. Posteriormente, los pacientes ingresaron para observación y, después del alta, se realizó un seguimiento por consultas externas. RESULTADOS: Ocho pacientes, 5 mujeres y 3 hombres, edad media: 78 ±15 años; 25% ASA I; 36% ASA II; 14% ASA III, y 25% ASA IV. Síntoma principal: disfagia. Tamaño de los divertículos: 1 a 7 cm. Éxito técnico: 100%. Complicaciones: un paciente con HDA. Estancia media: 24h. Siete pacientes: asintomáticos; un paciente con mejoría parcial, necesitando reintervención endoscópica. Cirugía y morbimortalidad: 0%. CONCLUSIÓN: El tratamiento del divertículo de Zenker mediante diverticulotomía endoscópica con Ligasure™ proporciona una gran eficacia, rapidez y seguridad, por lo que podría plantearse como primera elección de tratamiento

INTRODUCTION: Endoscopic treatment of Zenker diverticulum is considered feasible, effective and safe. The use of the Ligasure ™ vessel sealer provides adequate and quick dissection of tissue, achieving effective haemostasis. PATIENTS AND METHODS: Retrospective, descriptive study of all patients with Zenker diverticulum who were treated by endoscopic diverticulotomy using Ligasure™. The procedure was performed in the endoscopy unit under deep sedation controlled by the endoscopist. Patients were subsequently admitted for observation and, after discharge, were followed-up in the outpatient clinic. RESULTS: Eight patients, 5 women and 3 men, mean age 78 ±15 years, 25% ASA I, 36% ASA II, 14% ASA III and 25% ASA IV. Main symptom: dysphagia. Diverticula size: 1-7 cm. Technical success: 100%. Complications: one patient with upper gastrointestinal bleeding. Average stay: 24 h. Seven patients: asymptomatic; one patient with partial improvement, requiring repeat endoscopic intervention. Surgery and morbidity and mortality: 0%. CONCLUSION: The treatment of Zenker diverticulum by endoscopic diverticulotomy using the Ligasure ™ vessel sealer is highly effective, fast and safe, and could be considered the treatment of choice

Endoscopic diverticulotomy using Ligasure™. / Diverticulotomía endoscópica utilizando Ligasure™.

INTRODUCTION: Endoscopic treatment of Zenker diverticulum is considered feasible, effective and safe. The use of the Ligasure™ vessel sealer provides adequate and quick dissection of tissue, achieving effective haemostasis. PATIENTS AND METHODS: Retrospective, descriptive study of all patients with Zenker diverticulum who were treated by endoscopic diverticulotomy using Ligasure™. The procedure was performed in the endoscopy unit under deep sedation controlled by the endoscopist. Patients were subsequently admitted for observation and, after discharge, were followed-up in the outpatient clinic. RESULTS: Eight patients, 5 women and 3 men, mean age 78±15 years, 25% ASA I, 36% ASA II, 14% ASA III and 25% ASA IV. Main symptom: dysphagia. Diverticula size: 1-7cm. Technical success: 100%. COMPLICATIONS: one patient with upper gastrointestinal bleeding. Average stay: 24h. Seven patients: asymptomatic; one patient with partial improvement, requiring repeat endoscopic intervention. Surgery and morbidity and mortality: 0%. CONCLUSION: The treatment of Zenker diverticulum by endoscopic diverticulotomy using the Ligasure™ vessel sealer is highly effective, fast and safe, and could be considered the treatment of choice.