CHENNAI : A 73-year-old woman from Chennai was treated successfully at the Gleneagles Global Health City (GGHC), Chennai for Zenker’s diverticulum using Z-poem method. Prior to the treatment, she has had two years of intermittent history of food bolus impaction. The condition worsened over the last six months leading to progressive dysphagia and sensation of food impaction in throat, heart burns and regurgitation.
Zenker’s diverticulum (ZD) is rare, but a clinical condition typically seen in middle-aged and older adults, which needs medical intervention. The reported prevalence is 0.01 to 0.11%.
Dr B Mahadevan senior consultant and head of department — Medical Gastroenterology & Therapeutic Endoscopy, Gleneagles Global Health City, said, “It is the movement of food gets obstructed leading to chronic cough, spitting out of food, regurgitation and leading to further complications for normal living. Z- POEM Peroral endoscopic myotomy approach corrects Zenker’s Diverticulum was decided after a detailed analysis of the situation. Through Z-POEM we created an artificial tunnel between the muscle and mucosa on either side of the septum. This space is very narrow even for endoscopy to be performed. We have to divide the septum until the bottom of the oesophagus.”
Peroral endoscopic myotomy for Zenker’s Diverticulum (Z-POEM) is a modified novel technique used for treating swallowing disorder or achalasia cardia. Z-POEM involves the creation of a submucosal tunnel to facilitate complete visualization of the septum and division of the septum.
The potential risk of recurrence due to incomplete visualisation of the septum by conventional division of septum can be avoided with Z-POEM. This procedure can be meticulously performed on the elderly and high- risk patients for surgical repair so that there is less morbidity and early post-procedure recovery.