Hybrid endoscopic approach for submucosal tunneling septum division for Zenkerʼs diverticulum

A 71-year-old man was referred for a symptomatic Zenkerʼs diverticulum. The patient had undergone a stapled diverticulotomy 7 years ago. A barium esophagram revealed a 3-cm Zenker’s diverticulum with evidence of staples ([Fig. 1 a]). The decision was made to perform a peroral endoscopic myotomy of Zenker’s diverticulum (Z-POEM).