Intraoperative assessment of esophageal motility using FLIP during myotomy for achalasia

Campagna, Ryan A J; Carlson, Dustin A.; Hungness, Eric S.; Holmstrom, Amy L.; Pandolfino, John E.; Soper, Nathaniel J.; Teitelbaum, Ezra N.

doi:10.1007/s00464-019-07028-x

Cited by 34 publications

(19 citation statements)

References 26 publications

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“…The body of the esophagus was also investigated in patients with achalasia in six reports (ie, panometry) 37‐39,58,59,64 . Contrary to 95% (19/20) of HV, less than 1% (1/140) of patients with achalasia exhibited the RAC pattern as response to distension in a large cohort of patients 58 (LE 3).…”

Section: Resultsmentioning

confidence: 99%

“…All (106/106) patients with achalasia on HRM had abnormal FLIP topography (ie, abnormal EGJ DI, RRCs, absent contractility) but 50% (17/34) of patients with dysphagia and without major motility disorder on HRM had abnormal FLIP topography. One report showed that there was a modification of these abnormal contractility patterns following myotomy of the LES 37 (LE 3). Lastly, one recent report showed an excellent agreement (κ = 0.939; P < .01) between new real‐time panometry (FLIP 2.0) interpretation and classical post hoc panometry interpretation (MATLAB) for detecting major contractility disorders of the esophagus 39 …”

Section: Resultsmentioning

confidence: 99%

“…Seven studies (Table 4) included patients with other major motility disorders than achalasia (ie, esophago‐gastric junction outflow obstruction: EGJOO) 13,30,35‐39 . One study 36 showed that patients with EGJOO on HRM and pathological TBE had a lower EGJ DI ( P = .03) than patients with EGJOO on HRM and normal TBE (LE 3) with a cutoff value of 2.0 mm 2 /mm Hg (NPV: 100% and PPV: 75%).…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

The use of impedance planimetry (Endoscopic Functional Lumen Imaging Probe, EndoFLIP^®) in the gastrointestinal tract: A systematic review

Desprez

Roman

Leroi

et al. 2020

Neurogastroenterology Motil

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Background and purpose The EndoFLIP® system is a method of delineating impedance and was first designed to investigate the characteristics of the esophago‐gastric junction. In the last decade, its use was widened to investigate other sphincteric and non‐sphincteric systems of the gastrointestinal tract. The objective of the present systematic review was to summarize the available data in literature on the use of the EndoFLIP® system in the gastrointestinal tract, including sphincteric and non‐sphincteric regions. We performed a systematic review in accordance with recommendations for systematic review using PRISMA guidelines without date restriction, until June 2020, using MEDLINE‐PubMed, Cochrane Library, and Google Scholar databases. Only articles written in English were included in the present review. Five hundred and six unique citations were identified from all database combined. Of those, 95 met the inclusion criteria. There was a lack of standardization among studies in terms of anesthetic drugs use, probe placement, and inflation protocol. In most cases, only small cohorts of patients were included. Most studies investigated the EGJ, with a potential use of the EndoFLIP® to identify a subgroup of patients with achalasia and for intraoperative assessment of treatment efficacy in achalasia. However, the use of EndoFLIP® in the esophageal body (esophageal panometry), other esophageal diseases (gastro‐esophageal reflux disease, eosinophilic esophagitis), and other sphincter regions (anal canal, pylorus) will need further confirmatory studies. The EndoFLIP® system provides detailed geometric data of the gastrointestinal lumen but further works are needed to determine its use in clinical practice.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

The use of impedance planimetry (Endoscopic Functional Lumen Imaging Probe, EndoFLIP^®) in the gastrointestinal tract: A systematic review

Desprez

Roman

Leroi

et al. 2020

Neurogastroenterology Motil

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“…20 Other centers have reported the benefit of FLIP in tailoring pneumatic dilation, per-oral endoscopic myotomy, and/or Heller myotomy. [21][22][23][24][25][26][27][28] Dysphagia While achalasia is the quintessential esophageal motility disorder, it is relatively rare with an incidence often quoted at 1 per 100,000. 29 Dysphagia, on the other hand, is significantly more common with an annual incidence of approximately 4%.…”

Section: Achalasiamentioning

confidence: 99%

The functional lumen imaging probe in gastrointestinal disorders: the past, present, and future

Clarke

Ahuja

Fernandez‐Becker

et al. 2020

Annals of the New York Academy of Sciences

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The functional lumen imaging probe (FLIP) is a diagnostic tool that utilizes impedance planimetry to allow the assessment of luminal diameter and distensibility. It has been used primarily in esophageal diseases, in particular, in the assessment of achalasia, esophagogastric junction outflow obstruction, and eosinophilic esophagitis (EoE). The usage and publications have increased over the past decade and it is now an essential tool in the armamentarium of the esophagologist. Indications are emerging outside of the esophagus, in particular with regard to gastroparesis. Our paper will review the history of FLIP, optimal current usage, data for key esophageal disorders (including achalasia, reflux, and EoE), data for nonesophageal disorders, and our sense as to whether FLIP is ready for prime time, as well as gaps in evidence and suggestions for future research.

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“…Furthermore, a recent study showed that intraoperative use of FLIP can distinguish between type I/II and III precisely. 128 Dilation of esophagogastric junction FLIP technology can be used for dilation of the EGJ in patients with achalasia through a device called EsoFLIP (Medtronic Inc.) ( Table 1). The feasibility and clinical effectiveness of dilation using FLIP in patients with achalasia have been reported.…”

Section: Evaluation Of Esophagogastric Junction Distensibilitymentioning

confidence: 99%

Impedance in the evaluation of the esophagus

Sloan

Kuribayashi

et al. 2020

Annals of the New York Academy of Sciences

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The aim of this paper is to review esophageal electrical impedance technologies and to discuss the use of these technologies for physiological measurements, diagnostics, and therapy of esophageal disease. In order to develop a better understanding of the pathophysiology of and improve the diagnosis of esophageal disorders, such as gastroesophageal reflux disease (GERD) and achalasia, several new diagnostic tests, including intraluminal impedance, esophageal mucosal impedance, and the functional luminal imaging probe, have been developed. These technologies have proven valuable for assessment of the esophagus in recent years. They provide information on esophageal flow properties, mucosal integrity, lumen shape, and distensibility in esophageal disorders, in particular for GERD and achalasia. Despite their promise and novel clinical studies, the potential of these technologies has been far from realized. New multidisciplinary approaches will contribute to our understanding and interpretation of esophageal impedance data and disease mechanisms.

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Intraoperative assessment of esophageal motility using FLIP during myotomy for achalasia

Cited by 34 publications

References 26 publications

The use of impedance planimetry (Endoscopic Functional Lumen Imaging Probe, EndoFLIP^®) in the gastrointestinal tract: A systematic review

The use of impedance planimetry (Endoscopic Functional Lumen Imaging Probe, EndoFLIP^®) in the gastrointestinal tract: A systematic review

The functional lumen imaging probe in gastrointestinal disorders: the past, present, and future

Impedance in the evaluation of the esophagus

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Intraoperative assessment of esophageal motility using FLIP during myotomy for achalasia

Cited by 34 publications

References 26 publications

The use of impedance planimetry (Endoscopic Functional Lumen Imaging Probe, EndoFLIP®) in the gastrointestinal tract: A systematic review

The use of impedance planimetry (Endoscopic Functional Lumen Imaging Probe, EndoFLIP®) in the gastrointestinal tract: A systematic review

The functional lumen imaging probe in gastrointestinal disorders: the past, present, and future

Impedance in the evaluation of the esophagus

Contact Info

Product

Resources

About

The use of impedance planimetry (Endoscopic Functional Lumen Imaging Probe, EndoFLIP^®) in the gastrointestinal tract: A systematic review

The use of impedance planimetry (Endoscopic Functional Lumen Imaging Probe, EndoFLIP^®) in the gastrointestinal tract: A systematic review