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. 2021 Sep 15;6(12):562–567. doi: 10.1016/j.vgie.2021.08.003

Figure 2.

Figure 2

Standard Zenker’s peroral endoscopic myotomy (Z-POEM). A, Submucosal injection is performed a short distance proximal to the septum. B, Mucosal incision is performed. C, The submucosal space is entered. D, Submucosal tunneling is performed until the septum is reached. E, Submucosal dissection is performed on either side of the muscular septum. F, A stag beetle knife is used to transect the septum. G, Myotomy of the entire cricopharyngeus and extending a short distance distally. H, Mucosal closure using through-the-scope clips.