A Zenker’s Diverticulum (ZD) is a pouch that can form from a bulging in the muscular wall in the esophagus. This pouch can trap food, liquid, and pills. Patients may have cough, bad breath, difficulty swallowing, regurgitation, and a “gurgling” sensation in the throat. Many have difficulty swallowing, and rarely the retained material can result in aspiration (food or liquid spills into the windpipe) which could cause pneumonia. The surgery to repair this pouch is either done on the inside through your mouth (endoscopic) or through an incision in your neck (open). Most patients prefer the endoscopic approach because the procedure and the recovery is usually shorter. A majority of patients can have the endoscopic repair. For the others, we aren’t safely able to reach the pouch on the inside. For them, the open repair is an excellent option. 

The endoscopic surgery is a less invasive procedure that is performed by accessing the ZD with instrument placed through the mouth. There are no incisions or cuts on the outside of the neck. The surgeon may use a laser, surgical stapling, or both to treat the ZD. There is also a newer flexible endoscopic method, which can be used in patients with limited jaw and neck range of motion. However, at this time there is limited outcome data for this approach. Because the endoscopic approach is minimally invasive, patients often go home same day after surgery. 

If patients do not have adequate jaw opening or neck range of motion, they may need an open repair of the ZD. This requires an incision through the outside of this neck. Because this is a more invasive procedure, patients will need a longer recovery time. After surgery patients stay in the hospital for about three days for observation, and will have a temporary feeding tube placed through their nose. They will receive a swallowing test prior to leaving the hospital to make sure they are healed enough to start eating and drinking.