ASGE Esophagology General GI Practice Virtual Program (LIVE Virtual)

Video Transcription

Video Summary

In the video, Dr. Mohan Kashyap from Johns Hopkins Hospital discusses the treatment options for Zenker's diverticulum, a condition characterized by a pouch that forms in the wall of the esophagus. Surgical options, such as open myotomy and diverticulotomy, have been associated with significant risks and are less commonly used now. Alternative options include rigid endoscopy with stapled or laser diverticulotomy, as well as flexible endoscopic options like standard septotomy and Zenker's peroral endoscopic myotomy (Z-POEM). Dr. Kashyap explains that the fundamental step in managing Zenker's diverticulum is dividing the cricopharyngeus muscle fibers. He demonstrates the standard septotomy technique, which involves cutting the septum using a scissor-type knife, but notes that this approach can leave behind some septum and lead to recurrence. He then discusses the evolution of the Z-POEM technique, including an over-the-septum approach that simplifies the procedure and facilitates closure. Dr. Kashyap concludes by emphasizing that Z-POEM is an effective and safe treatment option for Zenker's diverticulum, but comparative trials are needed to assess its superiority in terms of symptom recurrence.

Asset Subtitle

Mouen Khashab

Keywords

Zenker's diverticulum

treatment options

surgical options

endoscopic options

Z-POEM