Flexible endoscopic treatment of a pharyngeal pouch

A pharyngeal pouch, also known as Zenker's diverticulum, occurs when part of the pharyngeal lining herniates through the muscles of the pharyngeal wall. It occurs mainly in older people. Presenting symptoms include dysphagia, regurgitation of undigested food, halitosis, hoarseness and chronic cough. It sometimes causes respiratory problems because of aspiration of the pouch contents into the lungs. As the pouch enlarges, symptoms become more severe and may result in weight loss and malnutrition. In a small proportion of patients, carcinoma may develop in the pouch.

The traditional treatment for a pharyngeal pouch involves open surgery to the neck. This may take the form of complete removal of the pouch or division of the muscle responsible for pouch formation (sometimes combined with inversion or invagination of the pouch). Endoscopic techniques using rigid endoscopes are also used, in which the wall between the pouch and the oesophagus is divided using diathermy, lasers or a stapling technique.