A new technology of endoscopic treatment of esophageal diverticula has been successfully introduced at the National Scientific Oncological Center. The positive experience of the doctors of our center makes it possible to transfer this technology for the treatment of Zenker's diverticulum to all regional surgical hospitals in Kazakhstan.

A 58-year-old male patient, upon admission, presented complaints of difficulty swallowing solid food and liquids, persistent bad breath and other accompanying symptoms. After examination, the patient was recommended surgical treatment.

As a result, the doctors performed endoscopic diverticulotomy of Zenker's diverticulum using a new technology developed by Japanese doctors. The peculiarity of the method is that the operation was performed intraluminal in the esophagus using a video gastroscope, without cutaneous incisions. The method is called Z-POEM-Zenker’s Oral Endoscopic Myotomy.

Previously, in the treatment of Zenker's diverticulum, only the "open" method of surgical treatment was used. It is still offered in many hospitals. In open surgery, the patient is made a rather large and long incision in the neck and Zenker's diverticulum is removed. Since the anatomy of the neck is extremely complex, there is a risk of transection of the recurrent laryngeal nerve, which can lead to the patient's loss of the ability to swallow normally. As a result of such an operation, a rather large scar remains on the neck.

When using the Z-POEM method, the cutaneous incision is not performed, the incision is made only of the esophageal mucosa, which means that the patient's rehabilitation is several times shorter, the patient can be discharged for 3-4 days in the absence of complications, labor rehabilitation is not required at all, and there is no risk of crossing the recurrent laryngeal nerve, as in surgical treatment. And most importantly, the patient's quality of life improves from the first hours after endoscopic surgery. Right after the operation, the patient is allowed to drink water.

The next day, under X-ray control, a control fluoroscopy of the esophagus using a water-soluble contrast is performed. The absence of contrast delay and contrast stains indicates a successful and correct operation. In the absence of complaints and with a generally satisfactory condition, the patient is discharged for 3-4 days, in dynamics endoscopic and X-ray control is carried out after six months.

The operation was performed by the head of the center for expert endoscopy and interventional radiology at the National Scientific and Research Center, Batyrbekov Kanat Umirzakovich, together with colleagues - the head of the endoscopy department of the Multidisciplinary Clinical Center, Aleksey Gennadievich Zeleny, and the endoscopist at the Center for Expert Endoscopy at the National Scientific Research Center of Galiakbarova Ainur Asylbekovna.

The successful implementation of such operations requires the use of expert endoscopic equipment and disposable endoscopic instruments, as well as high professional skills of the operating team.