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ENDOSCOPIC ZENKER'S DIVERTICULECTOMY Dr. Peter E. ANDERSEN, Drs. Cohen, Sheppard, Deveney & Meyers from the Oregon Health Sciences University, are presenting a case of Zenker's diverticulosomy with cricopharyngeal myotomy via an endoscopic approach. The Zenker's Diverticulum is caused by a malfunction of the superior esophageal sphincter (cricopharyngeal muscle). Traditionally the surgical approach for this problem consisted of lateral cervical incision with the resection of the diverticulum. With this new tran-oral endoscopic technique the septum between the diverticulum and the esophagus is divided by a stapling device and both lumens are "joined" creating a esophago-diverticulostomy. In addition a myotomy of the cricopharyngeal muscle is performed. Modified barium swallow showing the Zenker's Diverticulum. The Zenker's Diverticulum is the herniation of the mucosal sac between the fibers of the pharyngeal constrictor muscle and the crycophaeyngeus muscle. The surgical objective is to completely transect the crycopharyngeus muscle, which has caused the diverticulum. The endoscopic approach can transect the muscle dividing the common wall between the esophagus and the diverticulum. This creates a common single lumen. This pictures shows the "diverticuloscope", which allows good visualization and work space. This is a view of the esophagus which has been cannulated (anterior) and the Zenker's diverticulum (posterior) The endostapler is placed between the true lumen of the esophagus and the diverticulum. The endostapler is fired and removed. This picture shows three rows of staples that sealed off the crycopharingeal muscle. Laparoscopy.com would like to thank Dr. Peter E. ANDERSEN from the Oregon Health Sciences University for his video contribution entitled Zenker's Diverticulectomy with Cricopharyngeal Myotomy. The Endoscopic Approach.