Hybrid peroral endoscopic myotomy for large Zenker's diverticulum.

Abstract

Zenker’s diverticulum is considered a pulsation diverticulum developed in an area of weakness, known as the Killian’s triangle. Flexible endoscopic treatment of Zenker’s diverticulum was first introduced in 1982 and is now the first line of treatment [1] [2]. It consists of complete section of the abnormal septum by diverticulotomy, using an over-the-scope plastic diverticuloscope that allows stabilization and better exposure. However, this technique does not allow for the accurate estimation of complete myotomy and has a higher risk of perforation, mainly related to the blind introduction of the diverticuloscope [3].