Endoscopic discision of Zenker's diverticulum

Being typically an elderly make, the patient with a Zenker's diverticulum quite uncommonly presents in the best condition for surgery. Optimal management should therefore minimize the operative risk, shorten the time of postoperative hospitalization, and simultaneously avoid postoperative recurrence of the disorder. Using an automatic stapling device, the sphincter of the diverticulum (consisting mainly of the cricopharyngeus muscle) is cut easily endoscopically, with reliable haemostasis and a wide opening of the pouch as result. Six cases operated on by us between December 1993 and August 1994, became completely free of symptoms. The surgical technique (actually a variety of the traditional Dohlman's procedure) is described. Postoperative results over a follow-up of 3-8 months, and details of one non-serious postoperative complication are reported. Our experience of this pilot series gives rise to positive expectations of a new, safe, and time-saving procedure for successful treatment of even elderly patients with Zenker's diverticulum.