Operations for Zenker’s Diverticulum

Abstract

Zenker’s diverticulum is a false diverticulum or pseudodiverticulum of the esophageal mucosa and submucosa occurring at Killian’s dehiscence, which lies at the junction between the oblique fibers of the cricopharyngeus muscle and the transverse fibers of the inferior pharyngeal constrictor (Fig. 11.1). The Zenker’s diverticulum is a pulsion diverticulum thought to occur as a result of inadequate coordination between these muscle fibers, with a resultant increased pharyngoesophageal intraluminal pressure. The advent of endoscopic techniques has transformed the surgical treatment of Zenker’s diverticula. Although the treatment paradigm has shifted to minimally invasive approaches with repair assisted by endoscopic stapling or lasers, traditional transcervical procedures can still play a role in selected cases. This chapter illustrates our tailored approach to patients with Zenker’s diverticulum and demonstrates the open surgical and endoscopic techniques.