Killian-Jamieson diverticulum (KJD) is a rare cervical esophageal abnormality. Transcervical approach has been the main treatment modality to prevent recurrent laryngeal nerve (RLN) injury. We presented two cases of patients confirmed with KJD and were managed successfully under rigid endoscope. The new technique and idea were described in detail. Under rigid laryngoscope, the septum between the true esophagus lumen and diverticulum can be exposed clearly. A microscope equipped with CO LASER system offered precise and focused point cutting energy to the septum. Several efforts were applied to prevent RLN injury in the cases descriptions. We use transnasal esophagoscope and eating assessment tool (EAT-10) for anatomic and functional result evaluation. Much improved symptoms of dysphagia and intact RLN function were observed. Under the assist of rigid laryngoscope and point-cutting CO LASER, KJD diverticulotomy could be performed safely with little complication for patients refusing transcervical route.
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