Zenker's Diverticulectomy

Zenker’s diverticulum is an outpouching of an area where the pharynx is connected to the esophagus. In that area, there is a weak spot, called Killian’s triangle, and when the pressure from the swallowed food in the pharynx is high, the weak spot can herniate creating a sack-like outpouching on the back wall of the pharynx. The symptoms usually occur when the sack gets large permitting the food getting stuck in it, and include dysphagia (difficulty swallowing), regurgitation (backflow of the swallowed food into the mouth), cough, bad breath, and aspiration (swallowed food getting into the lungs). The surgery can correct this defect either through an open approach, which entails an incision on the side of the neck, or intraluminal approach using a rigid endoscope inserted through the mouth. With an open approach, the diverticulum is either excised (diverticulectomy), pulled back and upwards and sutured to the nearby structures (diverticulopexy), or inverted into the lumen of the esophagus and oversewn. In minimally invasive (endoscopic) approach, a diverticulum can be a) surgically combined with the lumen of the esophagus using laser or ultrasonic scalpel (diverticulostomy), or b) stapled from inside (diverticulotomy). Minimally invasive approach results in faster healing, less pain, and leaves no scar on the neck.