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. 2022 Mar 16;14(3):183–190. doi: 10.4253/wjge.v14.i3.183

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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.

This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

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Per-oral endoscopic myotomy for Zenker’s diverticulum. A: Endoscopic view of the Zenker’s diverticulum with muscle septum, located 20 cm from the incisors; B: The mucosal incision was performed after lifted submucosa by using glycerol with a few drops of indigo carmine injected at the septum; C: Submucosal tunneling and dissection was performed along both sides of the septal wall; D: A submucosal tunnel behind the ulcer contain many small vessel, we partially coagulate by coagrasper to stop bleeding and also avoid mucosal perforation; E: The ulcer after submucosal tunneling: The picture shows ulcer while checking mucosal integrity after performed submucosal tunneling before undergo myotomy; F and G: The myotomy was performed until the last fibers of septal muscle; H: The mucosal defect closed by through-the-scope clip.