Open Zenker’s-peroral endoscopic myotomy: novel treatment for Zenker's diverticulum

Zenker’s diverticulum (ZD) is an acquired pulsion type of false diverticulum caused by diminished compliance of the upper esophageal sphincter.1 The principle of treatment is to disrupt the integrity of the diverticulum by way of a cricopharyngeal (CP) myotomy. Traditional treatment is open surgical myotomy with excision of the diverticulum.2 Lately, however, the standard of care has shifted to minimally invasive endoscopic alternatives like endoscopic septotomy, or more recently, Zenker’s-peroral endoscopic myotomy (Z-POEM).