title: New endoscopic "scissors" to treat Zenker's diverticulum (with video).
abstract: BACKGROUND
  Zenker's diverticulum (ZD) is a rare disorder but is associated with significant morbidity. Cricopharyngeal (CP) myotomy is the mainstay of treatment, and various flexible endoscopic techniques have been used for division of the septum. However, there is a constant need for improvement in accessories.
  
  
  OBJECTIVE
  To evaluate the safety and effectiveness of a new electrocautery endoscopic scissor for CP myotomy in patients with symptomatic ZD.
  
  
  METHODS
  Observational human study.
  
  
  METHODS
  Tertiary-care hospital.
  
  
  METHODS
  This study involved 3 patients with symptomatic ZD.
  
  
  METHODS
  Flexible endoscopic CP myotomy was performed by using a novel scissors-type grasping device. CP myotomy involved 4 steps: (1) opening of the forceps, (2) grasping the muscle fiber, (3) closure of the forceps with application of gentle traction, and (4) dissection of muscle fibers by using cutting current. Intraprocedural bleeding was controlled with the same instrument by grasping vessels and applying coagulation current.
  
  
  METHODS
  Overall feasibility and performance, procedure time to achieve complete CP myotomy.
  
  
  RESULTS
  CP myotomy was successfully performed in all patients. Mean procedure time was 10.6 minutes. There were no major adverse events. Minor intraprocedure bleeding occurred in 1 patient.
  
  
  CONCLUSIONS
  Single arm, limited number of patients.
  
  
  CONCLUSIONS
  The new instrument has potential advantages in comparison with standard instruments used for CP myotomy. The advantages of this new technique are better control of cutting and hemostatic abilities.
authors.affiliation: Asian Institute of Gastroenterology, Hyderabad, India.
authors.forename: Mohan
authors.initials: M
authors.lastname: Ramchandani
authors.forename: D
authors.initials: D
authors.lastname: Nageshwar Reddy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004945:Esophagoscopy / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D010609:Pharyngeal Muscles / Q000601:surgery*; D013525:Surgical Instruments; D016896:Treatment Outcome; D016672:Zenker Diverticulum / Q000601:surgery*
keywords: CP; ESD; ZD; Zenker’s diverticulum; cricopharyngeal; endoscopic submucosal dissection