Endoscopic stapling of a pharyngeal pouch

A minimally invasive procedure to treat swallowing difficulties caused by a pharyngeal pouch.

What is endoscopic stapling

Endoscopic stapling treats a pharyngeal pouch through the mouth, usually using a rigid endoscope under general anaesthetic. A stapling instrument divides and seals the shared wall between the pouch and the food pipe, including the tight muscle at its upper end. This helps swallowed material drain more easily. Flexible endoscopic treatments are different procedures.

Why is it done

This procedure is offered to people with a pharyngeal pouch who have symptoms such as difficulty swallowing, coughing, food regurgitation, or recurrent chest infections. It helps relieve symptoms by improving the passage of food and reducing the chance of food getting trapped.

What are the benefits

• Improves swallowing.
• Reduces coughing and regurgitation.
• Minimally invasive (through the mouth, no cuts on the neck).
• Shorter recovery time compared to open surgery.

Are there any risks

Possible risks include a sore throat, bleeding, damage to teeth, lips or tongue, and persistent or returning swallowing symptoms.

A tear or leak can allow infection to develop in the neck or chest. This can be serious and may require antibiotics, tube feeding, a longer hospital stay or further surgery.

The pouch may not be accessible safely through the mouth, so the procedure may need to be stopped or a different treatment planned. Your surgeon will discuss individual risks and alternatives.

What happens during the procedure

You will be given a general anaesthetic (you will be asleep). A special endoscope is passed through your mouth to the pouch. The surgeon uses a stapling device to divide the wall between the pouch and the oesophagus, creating a single channel for food to pass through.

What happens after the procedure

• You may stay overnight or longer, depending on the procedure and your recovery. Your team will confirm when it is safe to go home.
• Do not eat or drink until your team says it is safe. Follow the staged fluid and food plan they give you; additional tests or tube feeding are sometimes needed.
• You may have a sore throat or mild discomfort.
• Follow-up will be arranged to check your recovery.

How long does recovery take

Most people feel better within a few days. You may need to gradually return to a normal diet. Avoid heavy lifting or strenuous activity for a short period as advised by your doctor.

When to seek medical advice

Get urgent hospital assessment for severe or increasing neck, throat or chest pain, fever, worsening swallowing, or inability to swallow fluids. Do not wait for a routine appointment.

Call 999 for breathing difficulty, collapse or substantial bleeding.

Other options

Depending on your symptoms and anatomy, options include observation, other endoscopic techniques or an operation through the neck. Discuss which approach is suitable for you.