Z-POEM Procedure
In addition to POEM, an endoscopic alternative to surgery for swallowing disorders like achalasia, patients suffering from Zenker’s diverticulum now have an alternative — Z-POEM.
Z-POEM, which stands for peroral endoscopic myotomy for Zenker’s, treats patients with Zenker’s diverticulum, a pouch that develops in the back of the throat. This pouch grows as muscles below it overtighten, and food can’t enter into the esophagus, eventually making swallowing difficult.
Prior to Z-POEM, two surgical options were available:
- Using a laser or stapler to cut the muscle through the mouth.
- A small cut on the neck to cut the muscle and possibly remove the pouch.
The UCI Health Chao Digestive Health Institute is the only center in Orange County with extensive expertise in performing the POEM procedure — and now the Z-POEM procedure.
After patients undergo the Z-POEM procedure and have the muscle removed, food easily enters the esophagus and no longer gets stuck within the Zenker’s diverticulum.
How Z-POEM works
Our esophageal specialist uses a micro knife to make a tiny incision at the top of the septum.
The specialist then cuts across the soft tissue opening to expose the muscle. Once the muscle is exposed, two short tunnels are created — one on the right of the muscle, and one on the left of the muscle. This is to completely expose the muscle while inside the small opening.
Now, the specialist can safely cut the muscle all the way down to the very last fiber, which guarantees no muscle is left behind. Then the specialist closes the small opening they created with short clips about a centimeter in size. These clips, once the opening heals, will fall out or down the esophagus into the stomach and out through the stool. As a result, food can move easily pass into the esophagus.
Typically, patients will stay overnight for observation and get a contrast X-ray study the next day prior to discharge.
For more information about the Z-POEM procedure, contact our esophageal disease specialists at 888-717-4463 or complete our online appointment request form ›