Devices and techniques for flexible endoscopic management of Zenker's diverticulum (with videos)

Pichamol Jirapinyo, Amrita Sethi, Barham K. Abu Dayyeh, Manoop S. Bhutani, Vinay Chandrasekhara, Nikhil A. Kumta, Joshua Melson, Rahul Pannala, Erik F. Rahimi, Guru Trikudanathan, John T. Maple, David R. Lichtenstein

Research output: Contribution to journalArticlepeer-review

Abstract

Background and Aims: Zenker's diverticulum (ZD) has traditionally been treated with open surgery or rigid endoscopy. With the advances in endoscopy, alternative flexible endoscopic treatments have been developed. Methods: This document reviews current endoscopic techniques and devices used to treat ZD. Results: The endoscopic techniques may be categorized as the traditional flexible endoscopic septal division and the more recent submucosal tunneling endoscopic septum division, also known as peroral endoscopic myotomy for ZD. This document also addresses clinical outcomes, safety, and financial considerations. Conclusions: Flexible endoscopic approaches treat symptomatic ZD with results that are favorable compared with traditional open surgical or rigid endoscopic alternatives.

Original languageEnglish (US)
Pages (from-to)3-13
Number of pages11
JournalGastrointestinal endoscopy
Volume94
Issue number1
DOIs
StatePublished - Jul 1 2021

Bibliographical note

Funding Information:
P. Jirapinyo has received research support from Apollo Endosurgery, Fractyl, and Lumendi; is a consultant for Endogastric Solutions; is a consultant for and has received research support from GI Dynamics; has received food and beverage and travel compensation from Boston Scientific; and has received travel compensation from Olympus. A. Sethi is a consultant for Olympus America Inc, Boston Scientific Corporation, Fujifilm, Medtronic, Micro-tech; has received food and beverage and travel compensation from ERBE, Covidien, Cook Medical, Endogastric solutions, and ER Squibb. B. Abu Dayyeh is a consultant for Metamodix, BFKW, DyaMx, Hemostasis; is a consultant for and receives research support from Medtronic; is a consultant for and has received food and beverage from Boston Scientific; receives research support and has received food and beverage from Apollo Endosurgery; has received research support from USGI, Spatz Medical, GI Dynamics, Cairn Diagnostics, and Aspire Bariatrics; is a speaker for Johnson and Johnson; is a speaker for and has received travel compensation and food and beverage from Endogastric Solutions and Olympus Corporation of the Americas; has received food and beverage from Covidien LP and Medrobotics Inc. M. Bhutani has received research grants from Silenseed Inc, Galera Inc, Oncosil Inc, Nanobiotix, and Augmenix Inc; has received food and beverage from Boston Scientific Corporation, Augmenix Inc, Olympus Corporation of the Americas, and Conmed Corporation. V. Chandrasekhara is a consultant for Covidien LLP; is on the advisory board for Interpace Diagnostics, and is a shareholder in Nevakar, Inc. N. Kumta is a consultant for Boston Scientific, Olympus Corporation of the Americas, Gyrus ACMI, Inc, and Apollo Endosurgery US Inc. J. Melson has received an investigator-initiated grant and food and beverage from Boston Scientific Corporation; has received food and beverage from Cook Medical LLC; and has stock options with Virgo Imaging. R. Pannala is a consultant for HCL Technologies, has received travel compensation and food and beverage from Boston Scientific Corporation, has received food and beverage from Apollo Endosurgery US Inc, and is on the scientific advisory board for Nestle Health Sciences. E. Rahimi has received food and beverage from AbbVie, Inc, Boston Scientific Corporation, and Covidien LP. G. Trikudanathan is a consultant and has received travel compensation and food and beverage from Boston Scientific Corporation; has received food and beverage from Cook Medical LLC. J. Maple has received food and beverage from Covidien LP, Olympus Corporation of the Americas, and Boston Scientific Corporation. D. Lichtenstein is a consultant for and has received travel compensation and food and beverage from Olympus America, Inc; is a consultant for Augmenix, Inc; and is a consultant for and has received food and beverage from Boston Scientific Corporation.

Funding Information:
The American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. Evidence-based methods are used, with a MEDLINE literature search to identify pertinent clinical studies on the topic. This is supplemented by accessing the ?related articles? feature of PubMed and by scrutinizing pertinent references cited by the identified studies. Controlled clinical trials are emphasized, but in many cases data from randomized controlled trials are lacking. In such cases, large case series, preliminary clinical studies, and expert opinions are used. Technical data are gathered from traditional and Web-based publications, proprietary publications, and informal communications with pertinent vendors. Technology Status Evaluation Reports are drafted by 1 or 2 members of the ASGE Technology Committee, reviewed and edited by the committee as a whole, and approved by the Governing Board of the ASGE. When financial guidance is indicated, the most recent coding data and list prices at the time of publication are provided. For this review the MEDLINE database was searched through March 2019 for articles related to endoscopic treatment of Zenker's diverticulum by using keywords such as ?endoscopy? or ?endoscopic? combined with ?Zenker? or ?Zenker's diverticulum,? among others. Technology Status Evaluation Reports are scientific reviews provided solely for educational and informational purposes. Technology Status Evaluation Reports are not rules and should not be construed as establishing a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment or payment for such treatment.

Publisher Copyright:
© 2021 American Society for Gastrointestinal Endoscopy

PubMed: MeSH publication types

  • Practice Guideline

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