TY - CHAP M1 - Book, Section TI - ZENKER’S DIVERTICULECTOMY A1 - Ellison, E. Christopher A1 - Zollinger, Robert M. PY - 2016 T2 - Zollinger's Atlas of Surgical Operations, 10e AB - The indications for repairing Zenker’s diverticulum are partial obstruction, dysphagia, a choking sensation, pain on swallowing, or coughing spells associated with aspirations of fluid from the diverticulum. The diagnosis is confirmed by a barium swallow. The pouch appears suspended by a narrow neck from the esophagus. Zenker’s diverticulum is a hernia of mucosa through a weak point located in the midline of the posterior wall of the esophagus where the inferior constrictors of the pharynx meet the cricopharyngeal muscle (figure 1). The neck of the diverticulum arises just above the cricopharyngeal muscle, lies behind the esophagus, and usually projects left of midline. Swallowed barium collects and remains in the herniated mucosa of the esophagus. The procedure described is an open technique and should be applied when a peroral stapling technique is not feasible. The open approach has the advantage of complete removal of the pouch with a low chance of recurrence. Furthermore, it provides a histological specimen to exclude carcinoma within the pouch. It may be useful in treating small pouches, with cricopharyngeal myotomy alone, which cannot be treated endoscopically. Disadvantages of the open procedure consist of a longer hospital stay and significant complications including recurrent laryngeal nerve injury and pharyngeal leak with mediastinitis. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesssurgery.mhmedical.com/content.aspx?aid=1127274586 ER -