An animal training model for endoscopic treatment of Zenker's diverticulum.
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.


METHODS
We prospectively characterized the endoscopy, the radiography, and the histologic anatomy of the pharyngeal diverticulum in the pig.


METHODS
Domestic pigs scheduled for euthanasia underwent radiography and endoscopy and, after euthanasia, neck dissection of the pharyngeal diverticulum.


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.
Seaman
Diahann L
DL
Developmental Endoscopy Unit, Mayo Clinic, Rochester, Minnesota 55905, USA.
de la Mora Levy
Jose
J
Gostout
Christopher J
CJ
Rajan
Elizabeth
E
Herman
Lori
L
Knipschield
Mary
M
D000284:Administration, Oral; D000818:Animals; D001466:Barium Sulfate / Q000008:administration & dosage; D003287:Contrast Media / Q000008:administration & dosage; D004195:Disease Models, Animal; D004501:Education, Medical / Q000379:methods*; D004945:Esophagoscopy / Q000379:methods*; D004947:Esophagus / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D010614:Pharynx / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D011446:Prospective Studies; D013552:Swine; D016896:Treatment Outcome; D016672:Zenker Diverticulum / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*
D003287:Contrast Media; D001466:Barium Sulfate