Treatment of Zenker Diverticulum

Abstract

The Zenker diverticulum (pharyngoesophageal diverticulum) arises from the triangle of mucosa located between the inferior pharyngeal constrictors and the cricopharyngeal muscle (Killian triangle). This type of diverticula is a false diverticulum and more common than true esophageal diverticula. The treatment options range from various endoscopic techniques to open surgical resection.

Treatment of Zenker diverticulum with a flexible endoscope provides an alternative to surgery or the intraluminal approach with a rigid endoscope (Weerda laryngoscope). The “septum” between the diverticulum and the esophagus is transected, thereby creating a common cavity of esophageal lumen and diverticulum, allowing easier food passage. It is not always necessary to divide the complete septum between the esophagus and the diverticulum because patients already have a good relief of symptoms after incision of one third to one half of the septum. That is why the aim of the endoscopic treatment is the relief of symptoms and not necessarily the complete separation of the septum.