# Cricopharyngeal myotomy using grasping scissors: Benefits of peroral endoscopic myotomy in symptomatic Zenker’s diverticulum

## TL;DR

This study shows that using grasping scissors for endoscopic myotomy is a safe and effective treatment for Zenker’s diverticulum, with most patients experiencing full symptom relief after one year.

## Contribution

The first large cohort study to evaluate the Clutch Cutter for endoscopic treatment of Zenker’s diverticulum, demonstrating its safety and long-term efficacy.

## Key findings

- No major complications occurred during the procedure, with only one minor wound reported.
- 97% of patients reported 100% improvement in symptoms at 12 months post-intervention.
- The average procedure time was 48 minutes, indicating it is a fast and efficient treatment.

## Abstract

Multiple therapeutic modalities, including surgery and rigid and flexible endoscopy, have been adopted to manage Zenker’s diverticulum (ZD). Relief from symptoms such as dysphagia and regurgitation is the main goal of therapy in symptomatic ZD. This study was the first large cohort that aimed to assess efficacy with time and safety of endoscopic diverticulotomy using the Clutch Cutter.

Cricopharyngeal myotomy was performed in 43 patients at Hospital Saint Joseph de Paris, a tertiary referral center. Symptoms were analyzed before and at 3, 6, and 12 months post-intervention using an extensive questionnaire about dysphagia, odynophagia, regurgitation, chronic cough, state of health, and complications. Procedure details such as duration, complications, and technical success were recorded.

Mean size of ZD was 25.6 mm. Mean procedure time was 48 minutes. No major complications (e.g., perforation, mediastinitis) occurred, although one patient suffered from a sinus piriform wound. Follow-up was performed at 3, 6, and 12 months. During follow-up consultations, patients rated improvement in their symptoms as a percentage. At 12 months, 97% of patients reported 100% improvement.

In patients with treatment-naïve ZD, the Clutch Cutter technique is safe, fast, and provides durable symptom remission.