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January 2003

Zenker Diverticulum

Arch Surg. 2003;138(1):111. doi:10.1001/archsurg.138.1.111

I read with interest the article by Yahara and Machi1 in the May issue of the ARCHIVES. I was dismayed, however, at the treatment suggested by the authors. Minimally invasive techniques have been ingeniously applied to this disease with excellent results.2-4 Using a specially designed laryngoscope, a laparoscopic stapler is inserted into the esophagus and positioned so that it straddles the opening of the diverticulum. When the instrument is fired, it opens the diverticulum and performs a myotomy at the same time. This can be repeated until the diverticulum is wide open. Although the radiographic picture is not pretty, the functional results are excellent. The patient can eat and is sent home the same day, and extensive surgery is avoided. This is all the more important because many of these patients are old, debilitated, and at high risk when undergoing extensive surgery.

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