Protrusions of the esophagus in the neck area, the so-called Zenker's diverticula, almost always require surgical treatment, as they usually cause complaints such as obstruction of the passage when swallowing (dysphagia), return of undigested chyme into the mouth (regurgitation), a feeling of pressure and tightness in the neck area and chronic irritable cough due to the transfer of chyme into the trachea (aspiration).
Depending on the size of the sacs, age and concomitant diseases of the patients, we offer different surgical procedures:
- open surgery (through an incision in the neck) removal of the diverticulum and simultaneous splitting of the thickened muscles of the upper esophageal sphincter, which is one of the causes of the diverticulum.
- the sole splitting of the thickened esophageal muscles in the cervical area (cervical myotomy) with leaving and / or sewing (fixation) of the diverticulum to the wall of the pharynx This procedure is considered for very small bulges of the esophagus.
- Another therapeutic option is the splitting of the diverticulum entrance from the inside with special devices that are introduced into the upper part of the esophagus via the mouth (transoral threshold splitting). This procedure must also be performed under general anesthesia.
The much rarer protrusions of the esophagus in its lower part, if they cause any discomfort to the patient at all, can be removed minimally invasively (i.e. without a large skin incision and opening of the thorax) by means of thoracoscopy. The same applies to the likewise rare benign tumors of the esophageal wall musculature (leiomyomas), if they have led to a narrowing of the esophagus or exceed a certain size, so that malignant growth must be feared.