Usefulness of the Hook knife in flexible endoscopic myotomy for Zenker’s diverticulum

Figure 1 Endoscopic procedure. A: Soft diverticuloscope in place, affording optimal exposure. Esophageal lumen is identified by the guidewire; B: The Hook knife is locked in 12 o’clock position; C: After initial incision, myotomy is performed, pulling the muscle fibers up before cutting; D: End of procedure, with 2 endoclips in place.

Figure 2 Clinical outcome of endoscopic myotomy.