Zenker’s Diverticulum

To treat Zenker’s diverticulum, surgery or other procedures may be needed. Eating softer foods in smaller bites might help with swallowing if you have mild symptoms of Zenker’s diverticulum. Your healthcare professional might suggest a dietician to help you learn what to eat.

Types of surgeries or other procedures

Repairing the esophagus with a procedure or surgery is the most common treatment for Zenker’s diverticulum that’s causing symptoms. Often, ear, nose and throat conditions (ENT) specialists do the procedure or surgery. They often do the procedure through a tube called an endoscope that goes into the mouth to the esophagus. This is less invasive than open surgery.

Endoscope procedures to repair Zenker’s diverticulum, sometimes called endoscopic repairs, most often have shorter surgery times and may have a shorter hospital stay compared to open surgery. They also often have similar results and improve Zenker’s diverticulum symptoms for people as much as open surgery. But people who have endoscope procedures might have a higher risk of a Zenker’s diverticulum coming back.

There are two main types of endoscope procedures used to repair Zenker’s diverticulum. They each take about 1 to 2 hours to do.

• Rigid endoscope procedure. Before the procedure, you’re given medicine called general anesthesia to put you into a sleeplike state. The ENT specialist uses a rigid endoscope to get to the esophagus. A rigid endoscope doesn’t bend or twist. The ENT specialist often uses a laser or may use a stapler to widen the opening to the bulge.

  Sometimes, the ENT specialist can remove the pouch with the laser device. This is called an endoscopic diverticulectomy. Electrocautery is another choice, but it’s rarely used with the rigid endoscope procedure.

• Flexible endoscope procedure. Before this procedure, you may get medicine that causes a near sleeplike state, called deep sedation, or general anesthesia. The endoscope is flexible. A surgeon uses an electric current, called electrocautery, to cut the bulge. Clips may be used for any bleeding.

Repairing Zenker’s diverticulum sometimes may need to be done in an open surgery, sometimes called an open repair. Before the procedure, you’re given general anesthesia. The ENT specialist makes a cut, called an incision, in the neck to remove the bulge.

This surgery most often takes 2 to 3 hours. People who have this type of surgery often stay in the hospital for one or more days. This surgery eases symptoms for most people.

Possible complications

Possible complications of surgery to repair Zenker’s diverticulum may include:

• Infection.
• Blood clots.
• Reactions to anesthesia.
• A hole in the esophagus.
• Dental injury such as a chipped tooth when surgery is done using an endoscope.

Results

Both endoscopic and open surgery ease Zenker’s diverticulum symptoms for most people. Endoscope procedures most often have shorter surgery times. Hospital stays often are just one night for endoscopic and open surgeries.

Open surgery leaves a small scar in the neck. Open surgery also can have a bit higher risk of a hole in the esophagus compared to endoscopic techniques. For a large Zenker’s diverticulum, open surgery may be the best choice for full removal of the pouch.

If the first procedure doesn’t ease symptoms or if Zenker’s diverticulum comes back, you may need another procedure. And if Zenker’s diverticulum comes back, it often has no symptoms. Researchers study newer ways of fixing the condition.