Guidewire-assisted technique for gastroscope insertion through stricture of Zenkerʼs diverticulum for esophageal endoscopic submucosal dissection

A 65-year-old asymptomatic man underwent screening esophagogastroduodenoscopy before treatment for tongue cancer. Standard gastroscopes (GIF-H290Z and GIF-H290; Olympus) could not pass through the cervical esophagus. However, an ultra-slim gastroscope (GIF-XP290N; Olympus) was able to pass through and revealed a Zenkerʼs diverticulum ([Fig. 1 a, b]). A superficial esophageal cancer was detected in the upper thoracic esophagus ([Fig. 2]). Biopsy...