Moore A, Vijendren A, Rajagopal R, Spraggs P
Department of ENT, St George's Healthcare NHS Trust, London, UK.
J Laryngol Otol. 2012 Apr;126(4):407-8. doi: 10.1017/S0022215111003392. Epub 2012 Jan 30.
Endoscopic hypopharyngeal diverticulotomy is now largely performed using an endoscopic stapling device. A poorly applied endoscopic stapling device can result in incomplete division of the cricopharyngeal bar, necessitating the application of a second set of staples. Applying more than one set of staples is associated with an increased risk of complications and greater cost. Small pharyngeal pouches are difficult to staple because of difficulties engaging the stapling device over the cricopharyngeal bar.
Two pairs of oesophageal forceps are used in conjunction with a 0 degree Hopkins rod to optimise the endoscopic stapling of small and large pharyngeal pouches.
Applying grasping forceps to the cricopharyngeal bar improves the accuracy of the stapling procedure, thus reducing the morbidity and cost associated with multiple staple applications.
目前，下咽憩室切开术大多使用内镜吻合器进行。内镜吻合器应用不当可能导致环咽肌切开不完全，从而需要再次使用吻合器。使用多组吻合器会增加并发症风险且成本更高。由于难以将吻合器放置在环咽肌上方，小型咽袋难以进行吻合。
使用两对食管钳与0度Hopkins杆配合，以优化大小咽袋的内镜吻合。
将抓钳应用于环咽肌可提高吻合操作的准确性，从而降低与多次使用吻合器相关的发病率和成本。
