Rigid Transoral Stapled Repair of Zenker’s Diverticulum

Zenker’s diverticulum (ZD) is a rare pulsion-type hypopharyngeal pseudodiverticulum caused by cricopharyngeal motor dysfunction that presents with dysphagia, regurgitation, cough, and aspiration in older adults. Diagnosis is established with contrast esophagram and endoscopy. Transoral stapled cricopharyngeal myotomy is performed using a rigid Weerda scope followed by mechanical stapler division of the common septum. Large contemporary series demonstrate excellent symptom relief, low perioperative morbidity, and staple-line leak rates of less than 1%. Conversion to open repair is required in 5% to 13% of patients because of unfavorable anatomy, while recurrence requiring reintervention occurs in 5% to 10%. Careful patient selection and meticulous operative technique are essential for optimal outcomes.