Endoscopic treatment of Zenker’s diverticulum using a new triangle tip knife

Authors Zaheer Nabi, Mohan Ramchandani, Nitin Jagtap, Santosh Darisetty, D.Nageshwar Reddy.


Background Zenker’s diverticulum (ZD) is a rare disease that affects elderly subjects. The mainstay of management is endoscopic myotomy of the cricopharyngeal septum. In this series, we aimed to evaluate the feasibility and efficacy of cricopharyngeal myotomy with a new electrosurgical knife in patients with ZD.

Methods Consecutive patients with ZD who underwent flexible endoscopic myotomy with the new triangle tip knife J (TTJ) were included in the study. The study outcomes included technical and clinical success, procedure duration, and adverse events.

Results A total of 7 patients [median age 57 (range 40-87) years] underwent cricopharyngeal myotomy with the TTJ knife. The median size of the ZD was 4 (range 3-5) cm. The procedure was successfully completed in all the patients with a median operative time of 12 (range 8-16) min. There were no major adverse events. Minor bleeding was noticed in 3 patients and was successfully managed using the same knife. Clinical resolution of symptoms was noticed in all the patients at follow up.

Conclusion Cricopharyngeal myotomy can be performed safely and efficiently with the new TTJ knife.

Keywords Endoscopy, diverticulum, esophagus, myotomy

Ann Gastroenterol 2019; 32 (6): 650-653

Case Series