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Jack Pickleman, MD
Chicago, Ill

Arch Surg. 1998;133:1133.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

This procedure does not get the respect it deserves, probably because on some days the operation can be remarkably easy. At other times, however, it can be distressingly difficult, and many a surgeon has been humbled by it. Several issues raised by the authors deserve comment. Whoever is performing the preoperative endoscopy should be advised of the diagnosis, as perforation can result from forceful entry into the diverticulum while mistaking it for the esophageal lumen. Except in unique circumstances, general anesthesia should be employed. The authors' recommendation for laryngoscopy at this point with suctioning and packing of the diverticulum seems to be an excellent one, as initial identification of the sac can occasionally be difficult. Although the authors hedge a bit regarding transection of the strap muscles, this step plus ligation of the middle and inferior thyroid vessels enhances exposure significantly. I must admit that I have . . . [Full Text of this Article]

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