Flexible Endoscopic Zenker's Diverticulotomy Using Needle Knife

Zenker's diverticulum (ZD) is the posterior pulsion diverticulum below the esophageal introitus through or above the cricopharyngeal muscle, and it is associated with a prominent cricopharyngeal bar. ZD can cause dysphagia, regurgitation of undigested food, cough, and aspiration of food particles. During endoscopy, ZD often creates difficulty in esophageal intubation. Flexible endoscopic treatment for ZD focuses on releasing the cricopharyngeal spasm by performing diverticulotomy on the septum. The aim of any endoscopic intervention is to reduce the septum, to relieve the cricopharyngeal spasm, and to increase the Zenker's esophageal diameter. The video of this article describes preprocedural evaluation, endoscopic techniques in diverticulotomy using needle knife, postprocedural care, and complications. This article is part of an expert video encyclopedia.