Volume 151, Issue 6, Pages (December 2016)

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Volume 151, Issue 6, Pages 1071-1074 (December 2016) Submucosal Tunneling Endoscopic Septum Division: A Novel Technique for Treating Zenker's Diverticulum Quan-Lin Li, Wei-Feng Chen, Xiao-Cen Zhang, Ming-Yan Cai, Yi-Qun Zhang, Jian-Wei Hu, Meng-Jiang He, Li-Qing Yao, Ping-Hong Zhou, Mei-Dong Xu Gastroenterology Volume 151, Issue 6, Pages 1071-1074 (December 2016) DOI: 10.1053/j.gastro.2016.08.064 Copyright © 2016 AGA Institute Terms and Conditions

Figure 1 The submucosal tunneling endoscopic septum division (STESD) technique. (A) A Zenker's diverticulum (black arrow). (B) Submucosal injection and mucosal incision toward the submucosal space. (C) Creation of the submucosal tunnel and clear exposure of the muscle fibers of septum inside the tunnel. (D) Septum division started inside the tunnel. (E) Complete myotomy beyond the bottom of the diverticulum. (F) Closure of mucosal entry. Gastroenterology 2016 151, 1071-1074DOI: (10.1053/j.gastro.2016.08.064) Copyright © 2016 AGA Institute Terms and Conditions

Figure 2 Submucosal tunneling endoscopic septum division (STESD) for the treatment of Zenker's diverticulum in a 45-year-old woman. (A) Visualization of a Zenker's diverticulum under barium swallow (black arrow). (B) A Zenker's diverticulum 18 cm from the incisors (black arrow). (C) Submucosal injection and mucosal incision 3 cm proximal to the diverticular septum. (D) Clear exposure of the muscle fibers of septum in the submucosal tunnel. (E) Septum division under direct endoscopic view. (F) Completion of myotomy. (G) Closure of the tunnel entry. (H, I) A completely incised diverticulum at 2-month follow-up esophagogastroduodenoscopy and barium swallow evaluations. Gastroenterology 2016 151, 1071-1074DOI: (10.1053/j.gastro.2016.08.064) Copyright © 2016 AGA Institute Terms and Conditions