A Case of Killian-Jamieson Diverticulum Resected Using Intraoperative Neural Monitoring and Intraoperative Esophagoscopy

Killian-Jamieson diverticulum (KJD) is indicated for surgical resection when accompanied by symptoms such as dysphagia. We experienced a case of KJD that was successfully resected using intraoperative neural monitoring (APS-NIMTM) and intraoperative esophagoscopy. The patient was a 64-year-old woman who presented with difficulty in swallowing. Esophagogastroduodenoscopy revealed an esophageal diverticulum. Since a proton pump inhibitor did not improve her complaint, she was referred to our hospital for further examination and treatment. A diverticulum measuring approximately 30 mm was found on the left side of the cervical esophagus. She was diagnosed with KJD and indicated for surgical treatment. We identified the left vagus nerve and attached an APS™ electrode. The esophageal diverticulum was confirmed and exfoliated. After the endoscope confirmed an appropriate diameter of the remaining esophageal lumen, the diverticulum was resected with a linear stapler. There was no abnormality in the APS-NIMTM signal during the operation. We report this case as an example of safe resection of KJD using intraoperative APS-NIMTM and esophagoscopy.