What are the advantages and disadvantages of endoscopic diverticulotomy with stapler for the treatment of Zenker diverticulum?

Updated: Oct 16, 2020
  • Author: Joel A Ernster, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
  • Print


A study by Bonavina et al indicated that transoral stapling is a safe and effective treatment for Zenker diverticulum, with dysphagia and regurgitation scores significantly improving over a median follow-up period of 63 months and the median number of annual pneumonia episodes being significantly reduced. The operation, performed on 100 patients in the study, had an overall long-term success rate of 76%; the success rate was higher in patients aged 70 years or older (who tended to have larger diverticula) and in cases in which traction sutures were used on the septum. [58]

A prospective study by Van Abel et al assessed short-term quality-of-life changes and functional outcomes following transoral diverticulotomy with CP myotomy, finding improvement in both of these measures. The changes were evaluated in 18 patients at 3 months postprocedure through the Reflux Symptom Index (improvement from 27 preprocedure to 5), the Functional Outcome of Swallowing Scale (improvement from 2 preprocedure to 0), and the 10-item Eating Assessment Tool (improvement from 21.5 preprocedure to 0). [59]

Advantages of endoscopic diverticulotomy with stapler include the following:

  • Short surgical time

  • Easily repeated

  • Quick return to oral alimentation

  • Short hospitalization

  • Less tissue trauma

  • Highly effective

Disadvantages include the following:

  • Unable to perform in some patients

  • Does not remove the diverticulum

  • No tissue for pathologic review

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!