Flexible Zenker's per-oral endoscopic myotomy

Q3 Medicine Operative Techniques in Otolaryngology - Head and Neck Surgery Pub Date : 2024-09-01 DOI:10.1016/j.otot.2023.12.002

Shumon Ian Dhar MD, FACS, Anna Tomkies MD

{"title":"Flexible Zenker's per-oral endoscopic myotomy","authors":"Shumon Ian Dhar MD, FACS, Anna Tomkies MD","doi":"10.1016/j.otot.2023.12.002","DOIUrl":null,"url":null,"abstract":"<div><div><span>Zenker's diverticulum<span> is a pulsion-type pseudodiverticulum of the pharyngoesophageal segment. Endoscopic surgery<span> is primarily directed at dividing the common wall between the esophagus and diverticulum. Rigid exposure with diverticuloscopes has allowed for common wall division with staplers, lasers, and advanced energy sealers, however, not all patients can be successfully treated with rigid instrumentation. As a result, flexible endoscopic surgery provides another option for patients. This technique employs various instrumentation through the working channel of a gastroscope to not only divide the common wall but seal the </span></span></span>incision, which if done appropriately, results in a symptom resolution with complication rates comparable to rigid techniques. Flexible endoscopic surgery requires the surgeon to perform technically challenging submucosal dissection through a gastroscope as well as possess expertise with advanced energy delivery systems and instrumentation. However, with time, surgeons can build these skills to offer a breadth of surgical options tailored to the individual patient.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"35 3","pages":"Pages 213-219"},"PeriodicalIF":0.0000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Operative Techniques in Otolaryngology - Head and Neck Surgery","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1043181023000817","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

Abstract

Zenker's diverticulum is a pulsion-type pseudodiverticulum of the pharyngoesophageal segment. Endoscopic surgery is primarily directed at dividing the common wall between the esophagus and diverticulum. Rigid exposure with diverticuloscopes has allowed for common wall division with staplers, lasers, and advanced energy sealers, however, not all patients can be successfully treated with rigid instrumentation. As a result, flexible endoscopic surgery provides another option for patients. This technique employs various instrumentation through the working channel of a gastroscope to not only divide the common wall but seal the incision, which if done appropriately, results in a symptom resolution with complication rates comparable to rigid techniques. Flexible endoscopic surgery requires the surgeon to perform technically challenging submucosal dissection through a gastroscope as well as possess expertise with advanced energy delivery systems and instrumentation. However, with time, surgeons can build these skills to offer a breadth of surgical options tailored to the individual patient.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

灵活的 Zenker 口周内窥镜肌切开术

曾克氏憩室是咽喉食管段的搏动型假性憩室。内窥镜手术的主要目的是分割食管和憩室之间的共同壁。使用憩室镜进行硬性暴露后，可使用订书机、激光和先进的能量封口器分割共同壁，但并非所有患者都能通过硬性器械成功治疗。因此，灵活的内窥镜手术为患者提供了另一种选择。这种技术通过胃镜的工作通道使用各种器械，不仅能分割胃壁，还能封闭切口，如果操作得当，症状可得到缓解，并发症发生率与刚性技术相当。柔性内窥镜手术要求外科医生通过胃镜进行具有技术挑战性的粘膜下剥离，并掌握先进能量传输系统和器械的专业知识。不过，随着时间的推移，外科医生可以掌握这些技能，为患者提供多种量身定制的手术方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Operative Techniques in Otolaryngology - Head and Neck Surgery Medicine-Otorhinolaryngology

CiteScore

0.70

自引率

0.00%

发文量

审稿时长

43 days

期刊介绍： This large-size, atlas-format journal presents detailed illustrations of new surgical procedures and techniques in otology, rhinology, laryngology, reconstructive head and neck surgery, and facial plastic surgery. Feature articles in each issue are related to a central theme by anatomic area or disease process. The journal will also often contain articles on complications, diagnosis, treatment or rehabilitation. New techniques that are non-operative are also featured.