Open Diverticulectomy and Myotomy
The Center for Minimally Invasive Esophageal Therapies at Boston Medical Center is here to serve you and your family, to provide you with the most advanced and effective medical treatment in New England—as well as unmatched patient care. Our dedicated staff works collaboratively to treat esophageal conditions such as Zenker's diverticulum in our state-of-the-art facilities. We perform such innovative procedures as diverticulectomy and myotomy, and work to lead you on the path to recovery in the most comfortable way possible.
Zenker's diverticulum is a condition characterized by a pouch that develops in the lower throat, next to the upper esophagus. This pouch presses on the esophagus and fills with food particles until it becomes full. At that point the esophagus is narrowed, making the passage of food difficult and uncomfortable. Nutrients and medications may not be able to be absorbed into the body through the stomach. The condition appears more often in men and women over the age of 50, and affects men more frequently than women.
There are currently no medications known to treat Zenker’s diverticulum. Surgery—either open or minimally invasive—is the main therapeutic approach. For open surgery, an incision is made in your neck muscle, called myotomy, and the diverticulum is taken out, which is called diverticulectomy. In the minimally invasive procedure, this is accomplished through the mouth under general anesthesia.
How to Prepare
It is important to follow any instructions given to you by your physician to prepare for surgery. These instructions generally include refraining from eating or drinking anything after midnight on the night before, bringing all of your medications with you to the hospital and arriving one hour before your surgery.
You may have a pre-admission appointment one to two weeks beforehand, in which you will have routine blood testing, any heart or esophageal imaging, and consultation with the anesthesiologist, who will administer medicine during your procedure that puts you to sleep and eases pain.
If possible, do some mild physical activity, such as walking, and eat a balanced diet leading up to your scheduled surgery. In the week before, try to follow the guidelines below:
- Limit alcohol consumption to one to two glasses a day.
- Stop using tobacco or cut back on the number of cigarettes you smoke each day.
- Make a list of all medications you take and bring it with you. Include prescription and over-the-counter medications, herbs, supplements, aspirin and corticosteroids.
What to Expect
On the day before your procedure, you should receive a call from us. You will be given information about the day of your surgery, including where to go and when to arrive. Leave any jewelry, credit cards or other valuables at home, and wear comfortable clothes.
When you arrive, you will be taken to a pre-surgery area so that we can take your temperature, blood pressure, pulse, and listen to your heart and lungs. We will place an intravenous (IV) line in a vein in your arm, so that medications and fluids may be administered before, during and after the procedure.
Your surgeon will make an incision in your neck, between your throat and esophagus, to reach the diverticulum. Once it is located, he or she will close off the pouch with a stitch or staple, and then remove it. The final step is to close your neck incision. Your surgery may take several hours.
After surgery, you will be taken to the Post Anesthesia Unit and monitored for any changes in blood pressure, heart rate, and breathing. An IV line will remain in your arm to keep you hydrated and administer pain medication, if necessary. If a breathing tube was inserted during surgery to control your breathing, it may remain in place for a brief time.
Before you go home, your physician or nurse will teach you how to care for your incision. Be sure to call your doctor if you notice any of the following:
- High temperature
- Allergic reaction, such as redness, swelling, trouble breathing
Always take your medicine exactly as prescribed. Call us if you have any questions or changes.