Which Stapler Is Used For Zenker’s Diverticulum Surgery?

What stapler is used for Zenker's diverticulum?

During conventional flexible endoscopic treatment of Zenker’s diverticulum (ZD), instruments such as needle knives, hook knives, or electrocautery are commonly used to incise the diverticular septum. However, this approach often presents several significant limitations and is not only technically cumbersome but also frequently associated with postoperative complications.

First, the incised septum is left unsealed, which increases the risk of intraoperative bleeding or cervical emphysema, thereby raising postoperative risk. Second, the limited working space within the flexible endoscope makes it challenging to precisely cut the distal muscle fibers of the septum; inadequate dissection may result in incomplete division, leading to symptom recurrence.

Moreover, conventional flexible endoscopic cutting techniques are highly dependent on operator experience, require longer procedure times, and make it difficult to achieve complete septal division while simultaneously protecting surrounding tissues. These limitations, to a certain extent, restrict the effectiveness and applicability of traditional flexible endoscopic treatment for ZD.

To overcome these limitations, a novel approach has recently been developed that combines a rotatable 5 mm surgical stapler (MicroCutter30 Xchange) with flexible endoscopy. This technique allows simultaneous division of the diverticular septum and closure of the incision under endoscopic visualization, effectively reducing the risk of intraoperative bleeding and perforation. Its rotatable design and reloadable feature enable flexible handling of septa of varying lengths and thicknesses, thereby increasing the success rate of the procedure. In addition, the technique is straightforward to perform, significantly shortens procedure time, and can be carried out under conscious sedation, reducing the risks associated with general anesthesia.

Preliminary clinical follow-up has shown that the majority of patients experienced significant relief of symptoms or complete resolution postoperatively, with a low recurrence rate. This technique not only preserves the minimally invasive nature and short hospital stay associated with flexible endoscopy but also enhances procedural safety and efficacy through the simultaneous cutting and closure of the septum, providing a more reliable and effective treatment option for patients with Zenker’s diverticulum.

Has the recovery time from Zenker’s diverticulum surgery become faster?

Although traditional open surgery for Zenker’s diverticulum (ZD) is highly effective, the postoperative recovery period is relatively long. It generally requires general anesthesia and involves healing of the cervical incision, postoperative pain, and gradual restoration of swallowing function. The average hospital stay can range from 5 to 10 days, and full recovery to a normal diet may take several weeks. In contrast, although conventional rigid or flexible endoscopic myotomy is minimally invasive, a certain postoperative recovery period is still required. In traditional flexible endoscopic procedures using instruments such as needle knives, hook knives, or electrocautery, patients typically require 1 to 3 days of liquid diet transition and short-term hospital observation to prevent complications such as bleeding or perforation, and full restoration of swallowing function is usually achieved within one to two weeks.

The innovative approach combining a rotatable 5 mm surgical stapler (MicroCutter30 Xchange) with flexible endoscopy allows simultaneous cutting and closure of the diverticular septum, effectively reducing the risk of intraoperative bleeding and perforation, and consequently accelerating postoperative recovery. According to available case series, patients were typically discharged approximately two days after the procedure, with liquid diet initiated on the day of surgery or the following day. The transition to solid foods was also markedly shortened, and postoperative swallowing function recovered well. Most patients experienced significant symptom improvement or complete resolution during follow-up. Compared with traditional surgery, this method not only reduces hospital stay by more than 70% but also provides a safer and more comfortable recovery process, significantly lowering medical risks for elderly patients and those with comorbidities.

How to choose the right surgical stapler for surgery?

Choosing the right surgical stapler is critical for surgical success and patient safety, as the type of surgery, tissue characteristics, patient condition, and stapler design all directly affect outcomes. Disposable Endoscopic Staplers provide strong and reliable closure through their titanium construction and excellent staple line consistency. Their 360° rotating and 45° articulating jaws enable easy single-hand operation, while a modular design streamlines workflow and reduces costs. Being disposable ensures sterility and safety. The accompanying Endoscopic Staplers Reloading Unit allows precise and reliable staple formation, is ergonomically designed, optimizes surgical efficiency, and supports optimal clinical outcomes.

Our staplers offer a range of staple heights and lengths to accommodate tissues of different thicknesses, ensuring secure closure without damaging tissue. The rotating and articulating design allows precise operation, while simultaneous cutting and stapling reduce the risk of bleeding and perforation. Reloadable features are ideal for long or multi-segment tissue applications, improving efficiency and reducing costs. Intuitive single-hand operation combined with endoscopic guidance shortens the learning curve, making the device easy to master. The minimally invasive, low-pressure design is especially suitable for elderly patients or those with comorbidities, shortening recovery time and allowing earlier discharge and return to normal diet. In modern minimally invasive surgery, Disposable Endoscopic Staplers, with their flexible design, simultaneous cutting and stapling, multiple size options, and reliable performance, have become the ideal choice for complex or narrow surgical sites, maximizing both safety and efficiency.

References：

World J Gastroenterol. 2017 May 7;23(17):3084-3091. doi: 10.3748/wjg.v23.i17.3084 0

New flexible endoscopic controlled stapler technique for the treatment ofZenker's diverticulum: A case series