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Flexible endoscopic clip-assisted Zenker's diverticulotomy (with videos)
1Division of Digestive Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas 75390-8887, USA.
Background:
In treating Zenker's diverticulum (ZD), there are potential risks associated with flexible endoscopic diverticulotomy without suturing or stapling. Rigid endoscopic stapler-assisted diverticulotomy has limitations. The septum is usually not completely dissected with either technique.
Objective:
Our purpose was to evaluate the feasibility of flexible endoscopic clip-assisted diverticulotomy (ECD) for complete septum dissection.
Design:
Case report.
Setting:
Academic center.
Patient:
An elderly male with symptomatic residual ZD.
Interventions:
After 1 endoclip (InScope multiclip applier, Ethicon Endo-Surgery) was placed on each side of the cricopharyngeal bar, the septum was easily and completely dissected between these 2 clips down to the bottom of the diverticulum into the esophageal mucosa with a needle-knife.
Main Outcome Measurement:
Symptom resolution and complications.
Results:
Complete esophageal symptom resolution without complications.
Limitation:
Case report.
Conclusions:
ECD is feasible, easy, safe, and effective for complete septum dissection. This is the first reported case of ECD. ECD provides another option in managing ZD with flexible endoscopy.
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