An esophageal diverticulum is an outpouching that develops in a weakened area of the esophagus. The condition goes by several names, depending on the location of the pouch. The most common form, Zenker’s Diverticulum is found at the level of the lower neck and usually at the back of the throat.

Zenker’s Diverticulum generally does not get smaller or heal without surgical intervention. In fact, the outpouching may grow larger and progressively increase the risks of aspiration and vomiting, and the development of pneumonia.

The most effective surgical treatment for this condition is a procedure that serves to relieve pressure in the esophagus and improve swallowing by cutting the muscular sphincter at the top of the esophagus. Called a Zenker’s Myotomy, this surgical treatment is often combined with the complete removal of the sac (Zenker’s Diverticuletomy). Both procedures can be done through traditional open surgery or minimally invasive endoscopic techniques. 

Our skilled thoracic surgeons are experienced in performing a wide range of surgical options for the repair of Zenker’s Diverticulum, allowing them to expertly determine the best course of treatment for your unique situation.

Preparing for Zenker’s Diverticulectomy/Myotomy

You will need to be seen by your primary care physician or gastroenterologist prior to undergoing a Zenker’s Diverticulectomy/Myotomy. Your pre-operative clearance will include a discussion of your medical history and a physical exam. You will also be required to undergo several diagnostic tests, including:

• A blood workup
• EKG
• Upper Endoscopy
• Upper GI Fluoroscopy Exam (barium swallow esophagram)

These tests will give your surgeon more information about your esophagus and stomach and determine the optimal surgical procedure(s) for the treatment of your condition.

What to Expect

Open surgery for a Zenker’s Diverticulectomy/Myotomy is performed under general anesthesia. An incision is made in the left side of the neck, the location where most diverticula are located. This type of surgery typically requires 1 or 2 nights in the hospital.

After the procedure, your pain will be controlled using one of several methods: a pump that delivers pain medicine through your intravenous line at your demand, by a nurse administering medicine through your intravenous line at your request, or through oral medicines. 

After your discharge from the hospital, you will want to make arrangements to have someone with you for the first couple of days if you live alone. You will not be able to drive until you are off of pain medicines.

For minimally invasive transoral stapling, an endoscope is inserted through the mouth. An endoscopic stapling device is then used to decrease the size or eliminate the pouch by stapling or closing off sections of it. An incisionless outpatient procedure, transoral stapling usually results in less pain, faster recovery and a quicker return to normal activities than open surgery. However, not every patient is a suitable candidate for this procedure. Your NorthShore thoracic surgeon will work with you to determine if this is the optimal treatment strategy for your particular diagnosis.

For More Information

To schedule an appointment with one of our thoracic surgeons, please call 847.570.2868.