Gastric diverticular are rare and usually are diagnosed incidentally on radiographic examination. Surgical treatment, consisting of simple excision or inversion of the
diverticulum, has been reserved for patients with proven symptoms or complications. These procedures have typically required
laparotomy, but with the development of advanced endoscopic techniques, a minimally invasive approach may be appropriate. The authors report two cases of
gastric diverticula managed laparoscopically and review the literature related to this entity. Between 1993 and 1996, two patients were evaluated for
dyspepsia-like gastrointestinal complaints. Both patients were found to have a
gastric diverticulum on a contrast study, and one
diverticulum was also seen on upper endoscopy. Laparoscopic resection was undertaken in both cases. Flexible gastroscopy was performed intraoperatively to help localize the
diverticulum, which was resected with an endoscopic stapling device. Nissen
fundoplication was performed in conjunction with the diverticulectomy in the second patient for
gastroesophageal reflux. Both procedures were completed laparoscopically without complications. The postoperative course was uneventful in both patients. At long-term follow-up, the patients are asymptomatic. This experience indicates that laparoscopic resection of symptomatic
gastric diverticula is a feasible alternative to
laparotomy. A prospective analysis to verify the safety and efficacy of this procedure should be done.