Flexible endoscopic clip-assisted Zenker's diverticulotomy (with videos).
BACKGROUND
In treating Zenker's diverticulum (ZD), there are potential risks associated with flexible endoscopic diverticulotomy without suturing or stapling. Rigid endoscopic stapler-assisted diverticulotomy has limitations. The septum is usually not completely dissected with either technique.


OBJECTIVE
Our purpose was to evaluate the feasibility of flexible endoscopic clip-assisted diverticulotomy (ECD) for complete septum dissection.


METHODS
Case report.


METHODS
Academic center.


METHODS
An elderly male with symptomatic residual ZD.


METHODS
After 1 endoclip (InScope multiclip applier, Ethicon Endo-Surgery) was placed on each side of the cricopharyngeal bar, the septum was easily and completely dissected between these 2 clips down to the bottom of the diverticulum into the esophageal mucosa with a needle-knife.


METHODS
Symptom resolution and complications.


RESULTS
Complete esophageal symptom resolution without complications.


CONCLUSIONS
Case report.


CONCLUSIONS
ECD is feasible, easy, safe, and effective for complete septum dissection. This is the first reported case of ECD. ECD provides another option in managing ZD with flexible endoscopy.
Tang
Shou-jiang
SJ
Division of Digestive Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas 75390-8887, USA.
Lara
Luis F
LF
D000369:Aged, 80 and over; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004867:Equipment Design; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D013536:Suture Techniques / Q000295:instrumentation*; D014741:Video Recording; D016672:Zenker Diverticulum / Q000601:surgery*