JOSEPH P. ALLEGRETTI, MD
CHICAGO. ILLINOIS

This study evaluates the novel technique of using fibrin sealant to avoid the complications of microendoscopic treatment of Zenker's diverticulum. For example, the endoscopic staple closure technique has demonstrated cases of mediastinitis and pneumomediastinum, as well as limitations in the sizes of diverticulum that can be treated. In our series of 10 patients, all were treated with C0₂ laser microendoscopic myotomy using the Dohlman diverticuloscope for exposure. With this technique, diverticula tissue bridges as small as 2 cm were successfully incised. All patients' myotomy openings were coated with fibrin sealant. There were no serious complications, and all patients went home before postoperative day 3, with most patients going home on postoperative day 1. In conclusion, C0₂ laser microendoscopic myotomy and fibrin sealant closure is a relatively safe technique with minimal complications, and applicability to all ranges of diverticula sizes.