Mayo Clinic gastroenterologist Ryan J. Law, D.O. , provides an overview of Zenker's diverticulum, including signs and symptoms, diagnosis, and a new minimally invasive approach to repairing a Zenker's diverticulum with peroral endoscopic myotomy (POEM).
With the treatment of sinkers diverticular um There's been an evolution over the last several decades with the goal to provide minimally invasive interventions that are aimed at improved outcomes. The definitive diagnosis for his anchors, diverticular um is upper endoscopy where the diverticular um would be seen directly as the scope passes into the esophagus. Another way to diagnose um this condition is with barium or contrast Asafa graham symptoms can include difficulty swallowing to the point where there is frequent regurgitation. In the most severe cases, patients may actually aspirate food or liquid into their lungs. Historically a sinkers diverticular um was treated surgically with an open neck dissection and actual removal of the diverticular um from the esophagus. Current minimally invasive therapies include both flexible and rigid endoscopic approaches. The rigid endoscopic approach involves placement of a rigid scope um in the back of the throat and into the proximal esophagus, followed by passage of any number of tools to divide the creek affair. Injurious muscle. The flexible procedures performed by passing the endoscope to the level of the diverticular um and subsequently the crackle fringes is divided using a variety of methods. The final approach developed within the last five years is something called a sinkers poem or sinkers per oral endoscopic my autumn E during a sinkers poem, A small sub mucosal tunnel is created immediately proximal to the level of the hypertrophic criteria for India's muscle. The scope is then passed underneath the lining of the proximal gi tract into the sub mucosal space And a tunnel is created on both sides of this hypertrophic muscle. The muscle is then subsequently divided using an electric knife, and the only requirement at that point to prevent adverse events is proper closure of the tunnel that we've created, which usually is a 1-2 centimeter opening at the very proximal aspect of the esophagus. A major benefit of the sinkers poem approach is the ability to preserve the overlying mucosa of the proximal esophagus, therefore minimizing the risk of infection after tunnel closure. Using the Z poem approach, it's very easy to identify anatomical landmarks as well as identifying the problem musculature. That requires treatment here at Mayo Clinic, we have as much experience as anybody in the country managing this condition. And we also have clinicians who are willing to take a multidisciplinary approach on a patient by patient basis to determine which approach may be right for each particular patient. The advent of zen poem is one such therapy where we continue to try and find new therapies, novel innovations to improve our patients lives with the least risk to them as possible. Okay,
