For the First Time in Armenia: Transoral Surgery for Esophageal Diverticulum Performed at Nairi Medical Center

For the first time in Armenia, a unique surgery — transoral esophagodiverticulostomy — has been performed: endoscopic removal of an esophageal diverticulum without incisions, through the oral cavity. This was reported by Professor Andranik Adamyan, Head of the First Surgical Department at Nairi Medical Center.

According to him, the patient was diagnosed with Zenker’s diverticulum, and on June 19, 2018, a team of surgeons led by Professor Adamyan performed the procedure transorally using a diverticuloscope, which allowed for esophagodiverticulostomy with endoscopic instruments. The duration and invasiveness of this surgery are minimal compared to traditional methods, which helps avoid many complications and enables patient discharge within 2–3 days.

Professor Adamyan explained that Zenker’s diverticulum (also known as hypopharyngeal-esophageal diverticulum) is the most common type of esophageal diverticulum. It is 3.5 times more frequent in men than in women. Common symptoms include throat irritation, dry cough, excessive salivation, sensation of a foreign body, intermittent swallowing difficulties, regurgitation of undigested food, and foul breath.

Such patients often develop malnutrition due to swallowing difficulties, which leads to hypovitaminosis, bronchitis, and pneumonia. Severe complications of Zenker’s diverticulum include inflammation and perforation, which may cause cervical phlegmon or mediastinitis. Perforation can also occur during medical procedures such as intubation or gastroscopy, since the diverticulum is located in such a way that food, probes, or scopes tend to enter it instead of the esophageal lumen.

Until recently, this disease was treated with rather complex and traumatic open surgeries, which often resulted in complications such as suture dehiscence, cervical phlegmon, mediastinitis, or fistula formation.

According to Professor Adamyan, Nairi Medical Center’s surgeons are the first in Armenia to master this innovative technique, made possible thanks to their high professionalism and the hospital’s advanced technical capabilities.

This is not the only innovative method introduced in Armenia by Professor Adamyan, who has also developed numerous surgical techniques for abdominal and thoracic organ pathologies, including oncological cases.