Post written by Kondal Kyanam Kabir Baig, MBBS, from the Division of Gastroenterology and Hepatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
We described a case of an elderly gentleman with cardiac comorbidities with symptomatic Zenker’s diverticulum and, in particular, a history of undergoing a Heimlich maneuver for choking. We used a needle knife (papillotome) for the initial incision and an IT knife for the completion of the myotomy. The video also demonstrates the initial NG tube placement and the safe use of clips to close the incision. The clinical response of the patient was excellent with complete relief of dysphagia.
We felt that this video was useful because it demonstrated the use of specific tools such as the needle knife and the IT knife, which are not conventional tools for this procedure. The video also shows that clip closure of the incision is easy and does not cause problems in the recovery period such as airway difficulty or foreign body sensation.
For those who perform this procedure, we demonstrate new tools and techniques. For community gastroenterologists, this video shows that in the right hands, Zenker’s myotomy is a safe, minimally invasive endoscopic procedure. Recognition of patients who are suitable for this intervention and appropriate referral to an endoscopist with such experience is important.
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