Pharyngeal pouch surgery

Written by: Mr Stuart Winter
Published:
Edited by: Cal Murphy

A pharyngeal pouch at the top of the oesophagus can cause food to stick in your throat, regurgitation, aspiration, and in extreme cases can even make it impossible to eat. Treating this condition usually involves surgery. Expert ENT surgeon Mr Stuart Winter is here to explain how this is done.

Endoscopic stapling/laser

These minimally invasive measures involve passing a rigid endoscope (a thin tube with a camera at the end) through the patient’s mouth and into the upper oesophagus to find the pouch. The camera is used to inspect the lining of the oesophagus.

Some endoscopes are equipped with a laser, which is used to divide the wall of the pharyngeal pouch, while others staple the pouch closed using the adjacent tissue so that food no longer becomes caught as it passes down the gullet. The sphincter (ring of muscle) at the top of the oesophagus is cut to reduce the chance of reoccurrence.

 

Post-operative care

Patients are usually allowed to drink fluid on the same day as the operation, but have to build back up to eating solid food. They will spend the night in hospital after the operation so that they can be monitored. They are usually sent home the following day.

 

Complications

Complications of endoscopic stapling and laser procedures are rare. Occasionally, patients experience damage to the teeth caused by the endoscope when it was in their mouth. In other cases, a hole can occur in the stapled pouch, which allows food and drink to leak into the neck. However, this should heal if allowed to rest, and a feeding tube may be used in the meantime.

Another potential problem is that in the long term the pharyngeal pouch can reform, meaning that further treatment may be needed in the future.

 

Open repair

As well as the minimally invasive methods, there is also the option of open surgery to repair a pharyngeal pouch. The patient will be given a general anaesthetic to render them unconscious and the surgeon makes an incision on the left side of the neck through which they can repair the pouch.

Learn more about pharyngeal pouches here!

If you wish to book an appointment with a surgeon with expertise in pharyngeal pouch surgery, visit Mr Winter’s Top Doctors profile.

By Mr Stuart Winter
Otolaryngology / ENT

Mr Stuart Winter is an experienced consultant ear, nose & throat (ENT) surgeon with a specialist interest in tumours of the head and neck. Based across the major private hospitals in Oxford, Mr Winter runs a full ENT practice for adults and children. He runs a specialist swallowing clinic at the Churchill Hospital. He holds, and has held a number of positions nationally including with NICE, ENT-UK, and is a member of the national Clinical Reference Group (CRG) for complex Head and Neck Cancer.

Originally qualifying from the University of Bristol, Mr Winter completed his surgical training in the south west of England, where he developed an early interest in head and neck cancer. In order to further develop advanced techniques for head and neck cancer and sinus surgery, he spent a year working at the Royal Adelaide Hospital in South Australia. During this time he received a number of awards, including the Lionel College Memorial Fellowship and the Ethicon Travelling Fellowship.

As Consultant Ear, Nose & Throat Surgeon at Oxford University Hospitals, Mr Winter leads an active research program into head and neck cancer, and to date has over 40 publications in peer-reviewed journals. He is regularly invited to speak at national and international conferences and he teaches on a number of local and national courses.

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