Microendoscopic surgery of the hypopharyngeal diverticulum using electrocoagulation or carbon dioxide laser

In 1964 we started to treat hypopharyngeal (Zenker's) diverticular endoscopically, using the procedure described by Dohlman. With the increase in the number of patients (274 patients up until 1982), the technique and the instruments used have improved. This paper describes the technique we have used since 1981, which involves exposure of the tissue bridge between esophagus and diverticulum with the aid of a specially designed scope and subsequent severance of this bridge under microscopic control. In 12 cases the bridge was severed by electrocoagulation, while the CO2 laser was used for this purpose in another 12 cases. Both techniques have given good results. Essential advantages or disadvantages of either of these methods could not be elicited. We regard the use of an operating microscope as a great improvement.