Abstract
A 76 year-old man with a history of dysphagia and previous food impactions requiring Heimlich maneuvers presented to our outpatient GI clinic for evaluation of dysphagia and was found to have a moderate-sized Zenker's diverticulum on barium swallow. The patient and his family preferred non-surgical remedy for his dysphagia and elected to be the first case of endoscopic Zenker's myotomy at our institution. The patient presented for endoscopy and was deemed an appropriate candidate. Prior to endoscopy there was significant difficulty with placement of the nasogastric tube but ultimately this was accomplished. Dissection of the cricopharyngeus muscle was performed. After dissection, two hemoclips were placed to secure the defect and the patient was admitted to the hospital for monitoring. No crepitus or subcutaneous emphysema was seen after the procedure. The patient's diet was advanced to clear liquids approximately 6 hours after the procedure and these were tolerated without difficulty. A follow-up esophagram was obtained that demonstrated no leak or perforation and the diverticulum had significantly decreased in size. The patient was discharged home in stable condition the following day. Watch the video: https://goo.gl/MZ8d9i
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