■ Verification of impermeability of the suture line is confirmed using insufflation of air via the gastroscope in conjunction with insertion of saline via the laparo-scope.
■ Non-ionic contrast media is preferred to Gastrografin for the postoperative swallow as it provides superior images and is less reactive if aspirated or inadvertently leaks into thorax or abdomen.
■ Small diverticula may be treated by plication and myotomy.
■ Gastric dysparesis. This usually settles with pro-kinetic agents, but may require pyloroplasty.
■ Intraoperative upper gastrointestinal endoscopy facilitates transillumination of the diverticulum, safe staple placement as well as suture line evaluation with insufflation.
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