A novel method to perform endoscopic myotomy for Zenker's diverticulum using submucosal dissection techniques

Prashant Kedia, Norio Fukami, Nikhil A. Kumta, Michel Kahaleh, Reem Z. Sharaiha

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

A Zenker's diverticulum arises from the cervical esophagus and results in a mucosal outpouching through Killian's triangle. Treatment for symptomatic Zenker's diverticulum is a diverticulotomy. Traditional therapy has been surgical cricopharyngeal myotomy via an open or transoral rigid endoscopic approach. Flexible endoscopic diverticulotomy for Zenker's diverticulum has similar efficacy and is associated with fewer complications. Various techniques and devices have been used for myotomy including needle-knife, hook-knife, monopolar forceps, argon plasma coagulation, and harmonic scalpel. The limitation of current techniques is the difficulty in gauging the extent to which the most inferior part of the septum should be cut in order to treat the disease adequately while minimizing the risk of perforation and subsequent mediastinitis. In the cases described here, diverticulotomy using an endoscopic submucosal dissection technique was employed for muscular fiber exposure and septal dissection (myotomy) using a multipurpose knife. The utilization of a multipurpose knife with injection capability may further improve the success and safety of this procedure. Larger, randomized, prospective trials are needed to confirm this notion, standardize the technique, and identify the appropriate patient population for different endoscopic options.

Original languageEnglish (US)
Pages (from-to)1119-1121
Number of pages3
JournalEndoscopy
Volume46
Issue number12
DOIs
StatePublished - Aug 6 2014
Externally publishedYes

Fingerprint

Zenker Diverticulum
Dissection
Argon Plasma Coagulation
Mediastinitis
Surgical Instruments
Esophagus
Needles
Safety
Equipment and Supplies
Injections
Therapeutics
Population

ASJC Scopus subject areas

  • Gastroenterology

Cite this

A novel method to perform endoscopic myotomy for Zenker's diverticulum using submucosal dissection techniques. / Kedia, Prashant; Fukami, Norio; Kumta, Nikhil A.; Kahaleh, Michel; Sharaiha, Reem Z.

In: Endoscopy, Vol. 46, No. 12, 06.08.2014, p. 1119-1121.

Research output: Contribution to journalArticle

Kedia, Prashant ; Fukami, Norio ; Kumta, Nikhil A. ; Kahaleh, Michel ; Sharaiha, Reem Z. / A novel method to perform endoscopic myotomy for Zenker's diverticulum using submucosal dissection techniques. In: Endoscopy. 2014 ; Vol. 46, No. 12. pp. 1119-1121.
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