Which statement describes a standard surgical option for Zenker's diverticulum that can be performed endoscopically?

• A. Endoscopic diverticulotomy/diverticulostomy
• B. Laparoscopic fundoplication
• C. Esophagectomy
• D. Gastric bypass

Answer: (A)

Zenker's diverticulum forms because the cricopharyngeal muscle doesn’t relax properly, creating a pouch that traps swallowed material. The surgical goal is to relieve this outflow obstruction by dividing the wall between the diverticulum and the esophagus, i.e., performing a cricopharyngeal myotomy. Doing this endoscopically—endoscopic diverticulotomy or diverticulostomy—cuts that septum from inside the esophagus, opening the passage and reducing the pressure that drives the pouch. It’s a standard, minimally invasive approach with good symptom relief and quicker recovery compared with open surgery. The other procedures listed are for different problems: laparoscopic fundoplication treats reflux, esophagectomy is for extensive disease such as cancer, and gastric bypass is for obesity, none of which target Zenker's diverticulum.