ASGE DDW Videos from Around the World | 2026-MODIFIED ZENKER'S PERORAL ENDOSCOPIC MYOTOMY FOR GIANT DIVERTICULUM USING A TUNNEL-FREE APPROACH, UNDERSALINE IMMERSION AND MUCOSAL TRIMMING

MODIFIED ZENKER'S PERORAL ENDOSCOPIC MYOTOMY FOR GIANT DIVERTICULUM USING A TUNNEL-FREE APPROACH, UNDERSALINE IMMERSION AND MUCOSAL TRIMMING

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Video Transcription

Video Summary

This video describes a modified Z-POEM for a giant 9-cm Zenker’s diverticulum causing severe dysphagia in a 59-year-old patient. The team used a tunnel-free, direct septal incision with under-saline immersion to improve visualization and safety in the tight working space. Miotomy was extended across the cricopharyngeus and 2 cm into the esophagus to reduce recurrence risk. Because of the large septum, mucosal trimming was performed before clip closure. Recovery was uneventful, with no leak on esophogram, and the patient was asymptomatic and eating normally at 6 months.

Asset Subtitle

Submitted by Georgios Mavrogenis

Keywords

Z-POEM

Zenker’s diverticulum

dysphagia

cricopharyngeus myotomy

endoscopic septal incision