Zenker's diverticulum: a new endoscopic treatment with a soft diverticuloscope.

BACKGROUND Recently developed treatments for Zenker's diverticulum include the use of a flexible endoscope, which is minimally invasive. A new endoscopic approach is described that uses a soft diverticuloscope to provide perfect exposure of the operative site and stabilizes the endoscope. METHODS A total of 30 patients (15 men, 15 women; median age, 78 years) were treated with this diverticuloscope. All patients had significant symptoms including dysphagia (n = 24, 80%) and/or regurgitation (n = 17, 56%). Eighteen (60%) had a large diverticulum (>4 cm). RESULTS All patients were successfully treated in a single session. In one patient, dysphagia persisted but was milder than before the treatment. A complication occurred in 4 patients (13%); in one (3%), it was severe. During follow-up (median, 12.5 months), dysphagia recurred in one patient 1 year after the initial procedure but was successfully re-treated with a CO(2) laser and rigid diverticuloscope. Four patients (13%) died during follow-up of causes unrelated to the treatment. CONCLUSIONS Diverticulotomy with a flexible endoscope and soft diverticuloscope is an effective treatment for Zenker's diverticulum.

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