Published clinical trials of transoral incisionless fundoplication (TIF) in GERD patients using older devices and techniques reported symptom improvement, but with variable effectson proton pump inhibitor (PPI) cessation and esophageal acid exposure. There are limited data on the outcomes of modern TIF performed by a therapeutic endoscopist usingimproved devices and techniques. Aim: We evaluated the… Read more »
Update on Endoscopic Approaches for the Management of Gastroesophageal Reflux Disease
Abstract: Gastroesophageal reflux disease (GERD) is one of the most commonly encountered gastrointestinal diseases in outpatient clinics. Proton pump inhibitors (PPIs) are the cornerstone of the treatment of GERD. However, approximately one-third of patients have suboptimal response to PPIs. The management options in such cases include antireflux surgery or endoscopic antireflux treatments. Antireflux surgery is… Read more »
A comparison of the endoscopic and laparoscopic view of the gastroesophageal junction in the use of transoral fundoplication
BACKGROUND: Endoscopic fundoplication requires accurate evaluation of the gastroesophageal junction (GJ) to determine if hiatal hernia repair is necessary before fundoplication. We compared the endoscopic and laparoscopic evaluations of the GJ. METHODS: A total of 53 patients with gastroesophageal reflux disease underwent a laparoscopic repair of a hiatal defect before endoscopic fundoplication. The video of… Read more »
Randomized controlled trial of transoral incisionless fundoplication vs. proton pump inhibitors for treatment of gastroesophageal reflux disease
OBJECTIVES: Transoral incisionless fundoplication (TIF) was developed in an attempt to create a minimally invasive endoscopic procedure that mimics antireflux surgery. The objective of this trial was to evaluate effectiveness of TIF compared with proton pump inhibition in a population consisting of gastroesophageal reflux disease (GERD) patients controlled with proton pump inhibitors (PPIs) who opted… Read more »
The effect of endoscopic fundoplication and proton pump inhibitors on baseline impedance and heartburn severity in GERD patients
BACKGROUND: Antireflux therapy may lead to recovery of impaired mucosal integrity in gastro-esophageal reflux disease (GERD) patients as reflected by an increase in baseline impedance. The study objective was to evaluate the effect of endoscopic fundoplication and proton pump inhibitor (PPI) PPI therapy on baseline impedance and heartburn severity in GERD patients. METHODS: Forty-seven GERD… 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 »