Commentary

Zenker’s peroral endoscopic myotomy (Z-POEM) is gaining popularity for treatment of Zenker’s diverticulum. Several technical modifications have evolved since its original description. The conventional double-tunnel approach is often technically hard because of difficulty in creating a tunnel on the esophageal side, whereas creation of the diverticular side tunnel is much easier. Mavrogenis et al. in this video describe a single-tunnel Z-POEM wherein, after protection of the esophageal mucosa with repeated submucosal injections, the septum is divided through a single diverticular side tunnel. The modification is novel, simple to adopt, and can significantly reduce procedure time. Risk of esophageal mucosal injury appears minimal.

This video shows a step towards further simplifying Z-POEM to enable more endoscopists to adopt the procedure in clinical practice.

Publication History

Article published online:
29 August 2023