Current status of endoscopic treatment for esophageal diverticulum based on diverticular peroral endoscopic myotomy

Figure 2 The choice of myotomy. A: When a diverticulum is located at the right side (2:00-5:00 position), a posterior myotomy should be performed at the 6:00-8:00 position; B: Conversely, if the diverticulum is situated on the left side (7:00-10:00 position), an anterior myotomy is recommended at the 1:00-2:00 position. For standard peroral endoscopic myotomy, Zenker’s peroral endoscopic myotomy or peroral endoscopic septotomy can be used as the foundation as appropriate, and lower esophageal sphincter myotomy is performed within the same tunnel (at least 2 cm beyond the gastroesophageal junction).