An animal training model for endoscopic treatment of Zenker's diverticulum{A figure is presented}

Background: Zenker's diverticulum (ZD) is an uncommon disease, which is typically treated surgically. The alternative to surgery is a diverticulotomy, performed endoscopically. Given the rarity of this condition, it is not possible to obtain training. There has been no animal model identified that resembles the disease in human beings. Objective: To present an animal model of ZD that resembles the disease in human beings. Design: We prospectively characterized the endoscopy, the radiography, and the histologic anatomy of the pharyngeal diverticulum in the pig. Settings: Domestic pigs scheduled for euthanasia underwent radiography and endoscopy and, after euthanasia, neck dissection of the pharyngeal diverticulum. Interventions and Methods: Thirteen consecutive animals were studied. Pictures were taken for the endoscopic view, as well as radiographies during barium swallow in 1 pig. The neck region was dissected, and the pharynx and the upper esophagus were extracted. The size of the diverticulum was measured, and the block was fixed in formalin. Fixed specimens were cut in the transverse and coronal axis, and pictures were taken. The septum between the diverticulum and the esophagus was reviewed microscopically. Results: The pharyngeal diverticulum measured an average of 2.7 cm (1.3-5 cm), depending on the size of the pig. From an endoscopic and radiologic perspective, the pig pharyngeal diverticulum is identical to a ZD. The septum contains muscle as well as fibrous tissue and fat. These anatomical characteristics closely resemble the anatomy in human beings. Conclusions: We believe that we established an animal training model for the endoscopic treatment of ZD.