Wirelessly Powered Endoscopically Implantable Devices into the Submucosa as the Possible Treatment of Gastroesophageal Reflux Disease

Hajer, Jan; Novák, Marek; Rosina, Jozef

doi:10.1155/2019/7459457

Cited by 6 publications

(4 citation statements)

References 17 publications

(22 reference statements)

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“…All patients had an increase in LES pressure after the procedure ( 58 ) ( Table 4 ). There is also a recent porcine study using battery-device for electrical stimulation but no human studies available yet ( 59 ). Given that most human studies are available from laparoscopic studies, further large human studies with endoscopic implantation of devices are needed.…”

Section: Advances In Endoscopic Treatments For Gerdmentioning

confidence: 99%

Advanced Endoscopic Imaging and Interventions in GERD: An Update and Future Directions

et al. 2021

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Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal diseases encountered in primary care and gastroenterology clinics. Most cases of GERD can be diagnosed based on clinical presentation and risk factors; however, some patients present with atypical symptoms, which can make diagnosis difficult. An esophagogastroduodenoscopy can be used to assist in diagnosis of GERD, though only half of these patients have visible endoscopic findings on standard white light endoscopy. This led to the development of new advanced endoscopic techniques that enhanced the diagnosis of GERD and related complications like squamous cell dysplasia, Barrett's esophagus, and early esophageal adenocarcinoma. This is conducted by improved detection of subtle irregularities in the mucosa and vascular structures through optical biopsies in real-time. Management of GERD includes lifestyle modifications, pharmacological therapy, endoscopic and surgical intervention. Minimally invasive endoscopic intervention can be an option in selected patients with small hiatal hernia and without complications of GERD. These endoscopic interventions include endoscopic fundoplication, endoscopic mucosal resection techniques, ablative techniques, creating mechanical barriers, and suturing and stapling devices. As these new advanced endoscopic techniques are emerging, data surrounding the indications, advantages and disadvantages of these techniques need a thorough understanding.

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Section: Advances In Endoscopic Treatments For Gerdmentioning

confidence: 99%

Advanced Endoscopic Imaging and Interventions in GERD: An Update and Future Directions

et al. 2021

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“…Further advances include the endoscopic placement of a battery‐less stimulator. As only porcine models have been used to test these battery‐less devices, human studies are needed before this can be considered a viable treatment option 12 . In the coming years, electrical stimulation of the LES is a potential technology that could be utilized to treat patients with GERD.…”

Section: Electrical Stimulation Of the Lesmentioning

confidence: 99%

Endoscopic treatments for GERD

Kushner

Awad

Mikami

et al. 2020

Annals of the New York Academy of Sciences

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Gastroesophageal reflux disease (GERD) is a condition with increasing prevalence and morbidity in the United States and worldwide. Despite advances in medical and surgical therapy over the last 30 years, gaps remain in the therapeutic profile of options. Flexible upper endoscopy offers the promise of filling in these gaps in a potentially minimally invasive approach. In this concise review, we focus on the plethora of endoluminal therapies available for the treatment of GERD. Therapies discussed include injectable agents, electrical stimulation of the lower esophageal sphincter, antireflux mucosectomy, radiofrequency ablation, and endoscopic suturing devices designed to create a fundoplication. As new endoscopic treatments become available, we come closer to the promise of the incisionless treatment of GERD. The known data surrounding the indications, benefits, and risks of these historical, current, and emerging approaches are reviewed in detail.

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“…The device was shown to reduce symptom scores and acid exposure time in patients who were partial responders to PPI, although this was only an uncontrolled before-after study [110]; bowel perforation, lead erosion and dysphagia have been reported postprocedure. A miniature device has been developed that can be implanted by an endoscope into the submucosal pocket near the lower oesophageal sphincter which is minimally invasive [111]. Overall, the exact efficacy of neurostimulation in refractory GERD is uncertain but may represent a future alternative in clinical practice.…”

Section: Oesophageal Neurostimulationmentioning

confidence: 99%

Optimal management of severe symptomatic gastroesophageal reflux disease

Talley

Irani

2020

J. Intern. Med.

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Gastroesophageal reflux disease (GERD) is a common disorder, and empirical proton pump inhibitor (PPI) treatment is often the first step of management; however, up to 40% of patients remain symptomatic despite PPI treatment. Refractory reflux refers to continued symptoms despite an adequate trial of PPI, and management remains challenging. The differential diagnosis is important; other oesophageal (e.g. eosinophilic oesophagitis) and gastroduodenal disorders (e.g. functional dyspepsia) should be ruled out, as this changes management. A combination of clinical assessment, endoscopic evaluation and in selected cases oesophageal function testing can help characterize patients with refractory reflux symptoms into oesophageal phenotypes so appropriate therapy can be more optimally targeted. Medical options then may include adding a H2 receptor antagonist, alginates, baclofen or antidepressant therapy, and there is emerging evidence for bile acid sequestrants and diaphragmatic breathing. The demonstration of a temporal association of symptoms with reflux events on pH‐impedance testing (reflux hypersensitivity) serves to focus the management on modulating oesophageal perception and reducing the reflux burden, or identifies those with no obvious pathophysiologic abnormalities (functional heartburn). Anti‐reflux surgery based on randomized controlled trial evidence has a role in reflux hypersensitivity or continued pathological acid reflux despite PPI in carefully considered, fully worked up cases that have failed medical therapy; approximately two of three cases will respond but there is a small risk of complications. In patients with persistent volume reflux despite medical therapy, given the lack of alternatives, anti‐reflux surgery is a consideration. Promising newer approaches include endoscopic techniques. This review aims to summarize current diagnostic approaches and critically evaluates the evidence for the efficacy of available treatments.

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Wirelessly Powered Endoscopically Implantable Devices into the Submucosa as the Possible Treatment of Gastroesophageal Reflux Disease

Cited by 6 publications

References 17 publications

Advanced Endoscopic Imaging and Interventions in GERD: An Update and Future Directions

Advanced Endoscopic Imaging and Interventions in GERD: An Update and Future Directions

Endoscopic treatments for GERD

Optimal management of severe symptomatic gastroesophageal reflux disease

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