Endoscopic septotomy of Zenker's diverticulum with Stag-Beetle Knife™: A descriptive observational study and literature review

Gastroenterol Hepatol. 2022 Jun-Jul;45(6):432-439. doi: 10.1016/j.gastrohep.2021.06.001. Epub 2021 Jun 12.
[Article in English, Spanish]

Abstract

Introduction: Zenker's diverticulum (ZD) is a protrusion of the hypopharyngeal mucosa with a prevalence of 2/100,000 inhabitants. The symptoms of the patients determine the need for treatment, which can be surgical or endoscopic. The latter, known as endoscopic septotomy or diverticulotomy (ED), this involves dissecting the diverticular septum, which can be performed with different dissection devices.

Aim: The aim of our study was to evaluate the efficacy and safety of ED with Stag-Beetle-Knife™ device, as well as to conduct a literature review to assess the position of the technique in the current scientific panorama.

Material and methods: Descriptive retrospective study that includes patients who underwent ED with SB-Knife™ between June 2017 and February 2020. Literature review of the available evidence between January 2013 and April 2020 of ED with SB-Knife™ technique and its variants.

Results: Twelve patients (66% male) with a median age of 70.5 years were collected. The median size of diverticular was 32.5mm and complete remission was observed in 75% of the cases. Fourteen interventions were performed with a technical success of 92.8. There were no serious complications. A literature review was carried out, finding 13 papers, of which 8 were finally included (6 retrospective studies, a series of cases and a clinical case).

Conclusion: Based on our experience and the reviewed literature, we consider ED with SB-Knife™ is a safe, effective and reproducible technique, and may be a better alternative to surgery in patients with ZD.

Keywords: Diverticulotomy; Diverticulotomía; Diverticulum; Divertículo; Literature review; Revisión de la literatura; Stag-Beetle-Knife™; Zenker.

Publication types

  • Review

MeSH terms

  • Animals
  • Coleoptera*
  • Endoscopy
  • Esophagoscopy / methods
  • Female
  • Humans
  • Male
  • Observational Studies as Topic
  • Retrospective Studies
  • Treatment Outcome
  • Zenker Diverticulum* / surgery