Surgical Resection of Laimer’s Diverticulum With Recurrent Laryngeal Nerve Preservation: A Case Report Highlighting Postoperative Suture-Line Edema Considerations

Laimer's diverticulum is a rare pharyngoesophageal diverticulum arising caudal to the cricopharyngeal muscle.A 75-year-old man with progressive postprandial food sticking underwent transcervical diverticulectomy.The diverticulum arose between the cricopharyngeal muscle and the longitudinal muscle of the cervical esophagus, supporting the intraoperative diagnosis of Laimer's diverticulum.Continuous intraoperative neuromonitoring was performed using an electrode placed on the left vagus nerve; the recurrent laryngeal nerve was identified and preserved, with no documented deterioration in neural responses.Resection was performed with a linear stapler, followed by suture reinforcement.On postoperative day (POD) 6, esophagography demonstrated focal narrowing and delayed esophageal passage without leakage, suggestive of suture-line edema.Oral trials were restricted because of impaired passage and documented airway entry of contrast-containing jelly.Endoscopy on POD 21 confirmed luminal patency; nevertheless, subsequent aspiration pneumonia and swallowing impairment necessitated further rehabilitation and nutritional support.The patient was transferred for continued care on POD 44.At followup on POD 128, he was alive, and no swallowing dysfunction was noted.This case emphasizes anatomical identification and cautious neural preservation, together with separate assessment of esophageal patency and swallowing safety; a protective effect of neuromonitoring cannot be established from a single case.