Submucosal per-oral endoscopic myotomy for a large Zenker’s diverticulum with use of a hydrodissector knife and an over-the-scope clip closure

Zenker’s diverticulum (ZD) is a herniation of the posterior hypopharyngeal wall, outpouching for Killian’s triangle as a consequence of decreased compliance of an upper esophageal sphincter. The standard endoscopic approach is represented by the incision of septum together with the mucosa.1-7