Endoscopic stapling of pharyngeal pouch (IPG22)
Fast, easy summary view of NICE guidance on 'ear nose and throat conditions'
The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on endoscopic stapling of pharyngeal pouch.
This procedure is used to treat pharyngeal pouch.
Pharyngeal pouch, which is also known as Zenker's diverticulum, occurs when the pharyneal lining herniates through the muscles of the pharyngeal wall. It occurs mainly in older people, with an estimated overall incidence of about 1 per 100,000 per year.
A pharyngeal pouch may cause difficulty in swallowing or cough, and sometimes causes respiratory problems because of aspiration of the pouch contents.
Endoscopic stapling of pharyngeal pouch involves stapling of the opening of the pharyngeal pouch through a specially designed endoscope, under general anaesthetic.
The standard treatment for pharyngeal pouches is open surgery to the neck. The most radical procedure, open diverticulectomy, involves complete removal of the pouch. For small pouches, there are less radical procedures involving cutting the muscle (the cricopharyngeus) around the neck of the pouch and sometimes inverting the pouch. People who have open neck surgery usually need to have nasogastric feeding for up to a week afterwards, and are at risk of serious complications such as mediastinitis.
Endoscopic techniques are less invasive. The standard endoscopic technique, known as Dohlman's procedure, involves diathermy or lasers to divide the wall between the pouch and the oesophagus.
E23.2 Operations on pharyngeal pouch
Y26.3 Stapling of organ NOC
Y76.3 Endoscopic approach to other body cavity
The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS. The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided. www.connectingforhealth.co.uk/clinicalcoding
- IPG22 Endoscopic stapling of pharyngeal pouch: guidance (web format)
- IPG22 Endoscopic stapling of pharyngeal pouch: guidance
- IPG022 Endoscopic stapling of pharyngeal pouch: understanding NICE guidance
- IPG22 Endoscopic stapling of pharyngeal pouch: distribution list
- Interventional procedures consultation document - endoscopic stapling of pharyngeal pouch
- Overview of endoscopic stapling of pharyngeal pouch
This guidance has been incorporated into the following NICE Pathways, along with other related guidance and products.
Visit the NICE Pathway: ear nose and throat conditions
This page was last updated: 06 February 2014
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