Stephanie M Novak, MS, Mason Hedberg, MD, Michael Ujiki, MD. NorthShore University Health System
INTRODUCTION: We present a video of a patient who underwent the flexible endoscopic method for treatment of a Zenker’s diverticulum
METHODS: The patient is an 87-year-old female who presented with dysphagia, regurgitation and cough. There was no history of Barrett’s and no gurgling, halitosis or aspiration pneumonia present. A two-centimeter Zenker’s diverticulum was noted at 17 cm. After diagnostic endoscopy, an H-180 upper endoscope with an EMR cap was inserted into the oropharynx. A mix of saline and methylene blue was used to lift the mucosa away from the underlying muscle and identify the submucosa. A mucosotomy was performed on the septum with the Hybrid I-Knife. The scope was then inserted into the submucosal space, which was dissected in a proximal to distal direction with the Hybrid I-Knife distal to the cricopharyngeus. A myotomy was then performed, again in a proximal to distal direction, starting at the septum and distal to the cricopharyngeus until the longitudinal and circular fibers were seen, by cauterizing the circular fibers of the esophagus with the Hybrid I-Knife. The mucosal defect was then closed with five through-the-scope clips.
RESULTS: The patient returned home on postoperative day zero and needed no pain medication. At the three-week follow up, all preoperative symptoms were one hundred percent resolved. A repeat esophagram at 6 months revealed no evidence of a persistent diverticulum.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87112
Program Number: V285
Presentation Session: Friday Video Loop (Non CME)
Presentation Type: VideoLoop