A double-incision endoscopic myotomy of the cricopharyngeal muscle for the management of a large hemi-circumferential Zenker’s diverticulum

An 81-year-old man with a decade-long history of dysphagia to solids presented to our hospital in extremis. He had lost 20 pounds in weight over 7 months, and more recently had been unable to tolerate clear fluids. A gastroscopy, barium swallow, and computed tomography scan revealed a large hemi-circumferential Zenker's diverticulum, located 18 cm from the incisors and centered at 9 o'clock ([Fig. 1] a), with minimal passage of contrast into the esophageal lumen observed.