Transoral, flexible endoscopic suturing for treatment of GERD: A multicenter trial

Filipi, Charles J.; Lehman, Glen A.; Rothstein, Richard I.; Raijman, Isaac; Stiegmann, Gregory V.; Waring, J. Patrick; Hunter, John G.; Gostout, Christopher J.; Edmundowicz, Steven A.; Dunne, Donal; Watson, Patrice; Cornet, Douglas A.

doi:10.1067/mge.2001.113502

Cited by 251 publications

(177 citation statements)

References 8 publications

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“…There may also be benefits in evaluating patients undergoing surgery and endoscopic therapies for such diseases in which the patients could be monitored before, during, and after treatment. It could for example be used down the working channel of an endoscope to determine the effects of endotherapies on reflux disease (6,16). This technique may also be useful in other sphincteric regions in the digestive tract and thus may become an important clinical instrument.…”

Section: Discussionmentioning

confidence: 99%

The functional lumen imaging probe (FLIP) for evaluation of the esophagogastric junction

McMahon

Frøkjær²,

Kunwald³

et al. 2007

American Journal of Physiology-Gastrointestinal and Liver Physi

133

136

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P, Drewes AM, Gregersen H. The functional lumen imaging probe (FLIP) for evaluation of the esophagogastric junction. Am J Physiol Gastrointest Liver Physiol 292: G377-G384, 2007. First published August 31, 2006; doi:10.1152/ajpgi.00311.2006.-There is a need for new methods to study the dynamics of the esophagogastric junction (EGJ). The aims were to verify the efficacy and usefulness of a "functional lumen imaging probe" (FLIP) for the evaluation of the EGJ. Eight healthy volunteers (6 men), median age 26 (21-35) yr, and two achalasia patients underwent the FLIP procedure. The EGJ was located by manometry. The FLIP measured eight cross-sectional areas (CSAs) 4 mm apart together with the pressure inside a saline-filled cylindrical bag. The data showed the geometric profile of the EGJ reconstructed in a video animation of its dynamic activity. A plot of curve-fitted data for the smallest CSA vs. pressure after balloon distension indicated that the pressure increased from 18 cmH 2O at a CSA of 38 mm 2 to a pressure of 37 cmH2O at a CSA of 230 mm 2 for the healthy controls. In one achalasia patient (unsuccessfully treated with dilations), the CSA never rose above the minimal measurable value despite the pressure increasing to 50 cmH2O. In another achalasia patient (successfully treated with dilations), the pressure only reached 15 cmH2O despite opening to a CSA of 250 mm 2 . In conclusion, FLIP represents the first dynamic technique to profile the function and anatomy of the EGJ. The method can be used practically to evaluate difficult cases of EGJ dysfunction and may provide a role in evaluating patients before and after therapies for diseases affecting the EGJ such as achalasia and gastroesophageal reflux disease. esophagus; competence; distensibility; cross-sectional area; functional imaging THE LOWER ESOPHAGEAL SPHINCTER (LES) is not solely responsible for impeding the flow between the esophagus and the stomach. The crural diaphragm encircles ϳ2 cm of the esophagogastric junction (EGJ), and the sling or oblique fibers of the stomach also contribute to the mechanism (15, 21). Esophageal and gastric motility, pressures in the abdominal and thoracic cavities, and the exact location of the EGJ all play a role in defining its function. The anatomy and behavior of the EGJ also change with time and body posture (20). The EGJ is a very dynamic mechanical structure. A lot of knowledge about the anatomy of the EGJ has been assembled over the last 40 years, but much of our limited understanding of the behavior has been related to manometric studies. Intraluminal pressure recording is the current gold standard for determining the motility characteristics of the esophagus. Although manometry provides useful information on the location of the EGJ and on phasic motility within the lumens of the digestive tract, it may be more restrictive in what it can tell us about sphincteric regions and their dynamics.Two classic diseases involving the EGJ are gastroesophageal reflux disease (GERD) and achalasia. Achalasia is an esophageal ...

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Section: Discussionmentioning

confidence: 99%

The functional lumen imaging probe (FLIP) for evaluation of the esophagogastric junction

McMahon

Frøkjær²,

Kunwald³

et al. 2007

American Journal of Physiology-Gastrointestinal and Liver Physi

133

136

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“…Six months after treatment with the first endoscopic sewing device (Endocinch; Bard, Murray Hill, NJ), 62% of 64 patients in the initial report were off PPIs (133). Extended follow-up of a small number of these patients (39) has been presented as an abstract, which suggested that less than 25% of patients were able to remain off medications for 2 yr (134).…”

Section: Level Of Evidence: IIImentioning

confidence: 99%

Updated Guidelines for the Diagnosis and Treatment of Gastroesophageal Reflux Disease

DeVault

Castell

2005

Am J Gastroenterology

797

493

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“…Normally the haemorrhage would stop when the two stitches are tied together as a plication [43,44,45,46]. Major adverse events like perforation have been reported in 2 cases [44, 45]. One patient was discharged home after a 3-day course of intravenous antibiotics [44].…”

Section: Endocinchmentioning

confidence: 99%

“…On both occasions we observed the patients overnight, and they were discharged well the following day. Normally the haemorrhage would stop when the two stitches are tied together as a plication [43,44,45,46]. Major adverse events like perforation have been reported in 2 cases [44, 45].…”

Section: Endocinchmentioning

confidence: 99%

EndoCinch® Treatment for Gastro-Oesophageal Reflux Disease

Mahmood

Ang²

2007

Digestion

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Gastro-oesophageal reflux disease (GORD) is a common disorder which significantly impairs the quality of life. Recently an EndoCinch® system has been described, with an approach to the treatment of GORD that would obviate the need for long-term proton pump inhibitors and the cost and potential risk of laparoscopic Nissen fundoplication. We set outto evaluate the status of this new technique for the management of GORD. We review the literatures (publications and abstracts) regarding safety, efficacy, and durability of this new antireflux procedure. On the whole, this new antireflux technique produced significant improvement in GORD symptomatology and quality of life and reduced the use of antireflux medication. However, it failed to normalize acid reflux, long-term durability data are lacking, and some serious side effects have been reported. In conclusion, EndoCinch has the potential to treat patients with this common ailment. However, further studies are necessary to determine what modifications to this antireflux technique are required in order to produce the maximum clinical benefit.

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Transoral, flexible endoscopic suturing for treatment of GERD: A multicenter trial

Cited by 251 publications

References 8 publications

The functional lumen imaging probe (FLIP) for evaluation of the esophagogastric junction

The functional lumen imaging probe (FLIP) for evaluation of the esophagogastric junction

Updated Guidelines for the Diagnosis and Treatment of Gastroesophageal Reflux Disease

EndoCinch® Treatment for Gastro-Oesophageal Reflux Disease

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