BACKGROUND: The functional lumen imaging probe (FLIP) uses impedance planimetry to measure the geometry of a distensible organ. The purpose of this study was to evaluate FLIP as a method to determine structural changes at the gastroesophageal junction (GEJ) following transoral incisionless fundoplication (TIF) and compare these findings with the accepted methods of esophageal testing.… Read more »
Heller myotomy and intraluminal fundoplication: a NOTES technique (Multimedia manuscript)
BACKGROUND: It is generally accepted that the most effective treatment of achalasia is a surgical myotomy. Nevertheless, if a myotomy alone is performed, reflux may occur in up to 30% of patients. The aim of this study was to explore a transoral incisionless stepwise approach to both esophageal Heller myotomy and fundoplication. METHODS: The first… Read more »
Transoral endoscopic fundoplication in the treatment of gastroesophageal reflux disease: the anatomic and physiologic basis for reconstruction of the esophagogastric junction using a novel device
OBJECTIVE: To determine the safety, mechanism of action, immediate postprocedural anatomic impact on the esophagogastric junction, and short-term efficacy of the first entirely endolumenal antireflux procedure. BACKGROUND: A safe and effective endoscopic antireflux procedure remains elusive. Transoral endolumenal surgery has enormous potential for the treatment of gastroesophageal reflux disease (GERD) and other esophagogastric diseases. A… Read more »
Endoluminal fundoplication (ELF): evolution of EsophyX, a new surgical device for transoral surgery
A novel endoluminal fundoplication (ELF) technique using a trans-oral and fastener-deploying device (EsophyX, EndoGastric Solutions) was developed and evaluated for feasibility, safety and the treatment of gastroesophageal reflux disease (GERD) in a series of bench, animal, human (phase 1, phase 2, commercial registry) studies. The studies verified biological compatibility, durability and non-toxicity of the polypropylene… Read more »
Gastroesophageal sphincter: a model
Abstract There is substantial experimental and anatomic evidence suggesting that the human lower esophageal sphincter is not a muscular ring but has its correlate in the arrangement of the so-called muscular clasps and oblique sling fibers at the gastroesophageal junction. We assessed the mode of action of these distinct muscle units in a mechanical model.… Read more »
Responses of feline gastroesophageal junction to changes in abdominal pressure
The responses of the lower esophageal sphincter (LES), stomach, and diaphragm and their contribution to changes in the high-pressure zone (HPZ) at the gastroesophageal junction were determined during extrinsic abdominal compression or intragastric balloon distension in anesthetized cats. Abdominal compression consistently induced an increase in intraluminal end-expiratory LES and gastric pressure (P less than 0.01).… Read more »
Role of the diaphragm in the genesis of lower esophageal sphincter pressure in the cat
To determine the role of the diaphragm in the genesis of the high-pressure zone at the lower esophageal sphincter (LES) we studied the effect of diaphragmatic contraction on lower esophageal sphincter pressure in 10 anesthetized adult cats. Despite anchoring the pressure recording assembly within the LES to prevent axial movement of the sphincter during respiration… Read more »
A valve mechanism to prevent gastroesophageal reflux and esophagitis
Adler RH, Firme CN, Lanigan JM. A valve mechanism to prevent gastroesophageal reflux and esophagitis. Surgery. 1958;44:63-75. After searches in PubMed.gov, Amazon.com and AbeBooks.com we were unable to locate a digital copy of this peer-reviewed clinical publication. This material may be protected by copyright law. It is our intent to honor Drs Richard H Adler,… Read more »