Abstract: Gastroesophageal reflux disease (GERD) is a common and costly chronic medical condition affecting millions of patients. It is associated with substantial morbidity and negatively impacts quality of life. Reflux of gastric contents into the esophagus damages the esophageal mucosa and is associated with conditions including esophagitis and esophageal stricture. While GERD is most commonly… Read more »
Effect of transoral incisionless fundoplication on reflux mechanisms
OBJECTIVES: Transoral incisionless fundoplication (TIF) is a new endoscopic treatment option for gastroesophageal reflux disease (GERD). The mechanisms underlying the anti-reflux effect of this new procedure have not been studied. We therefore conducted this explorative study to evaluate the effect of TIF on reflux mechanisms, focusing on transient lower esophageal sphincter relaxations (TLESRs) and esophagogastric… Read more »
The effects of transoral incisionless fundoplication on chronic GERD patients: 12-month prospective multicenter experience
PURPOSE: This study aimed to assess the impact of transoral incisionless fundoplication (TIF) on patients with chronic gastroesophageal reflux disease (GERD) at 12-month follow-up. METHODS: Clinical outcomes of 100 consecutive patients with chronic GERD who underwent TIF between January 2010 and February 2011 were analyzed. RESULTS: There were no major complications reported. Esophageal acid exposure… Read more »
Impact of transoral incisionless fundoplication (TIF) on subjective and objective GERD indices: a systematic review of the published literature
BACKGROUND: Gastroesophageal reflux disease (GERD) remains a significant problem for the medical community. Many endoluminal treatments for GERD have been developed with little success. Currently, transoral incisionless fundoplication (TIF) attempts to recreate a surgical fundoplication through placement of full-thickness polypropylene H-fasteners. This, the most recent procedure to gain FDA approval, has shown some promise in… Read more »
Esophagopulmonary fistula and left lung abscess after transoral incisionless fundoplication
Endoscopic treatment of gastroesophageal reflux disease (GERD) is emerging as an alternative to open, laparoscopic, or robotic antireflux surgical procedures. Early transoral devices failed because of poor efficacy and serious adverse events. In recent trials the EsophyX device has demonstrated acceptable safety and a reasonable efficacy profile. We present the case of a woman who… Read more »
Three-year Results of a Multicenter Prospective Study of Transoral Incisionless Fundoplication
BACKGROUND: To date, there are no long-term data on the use of transoral incisionless fundoplication (TIF) for the treatment of chronic gastroesophageal reflux disease (GERD). We sought to prospectively evaluate the long-term safety and durability of TIF in a multi-center setting. METHODS: A longitudinal per protocol (PP) and a modified intention-to-treat (mITT) analysis at 1… Read more »
Revisional laparoscopic antireflux surgery after unsuccessful endoscopic fundoplication
BACKGROUND: Transoral incisionless fundoplication (TIF), a novel endoscopic procedure for treating gastroesophageal reflux disease (GERD), currently is under evaluation. In case of treatment failure, subsequent revisional laparoscopic antireflux surgery (rLARS) may be required. This study aimed to evaluate the feasibility, safety, and outcomes of revisional antireflux surgery after previous endoscopic fundoplication. METHODS: Chronic GERD patients… Read more »
Causes of dissatisfaction after laparoscopic fundoplication: the impact of new symptoms, recurrent symptoms, and the patient experience
BACKGROUND: Although laparoscopic fundoplication effectively alleviates gastroesophageal reflux disease (GERD) in the great majority of patients, some patients remain dissatisfied after the operation. This study was undertaken to report the outcomes of these patients and to determine the causes of dissatisfaction after laparoscopic fundoplication. METHODS: All patients undergoing laparoscopic fundoplication in the authors’ series from… Read more »
Transoral incisionless fundoplication does not significantly increase morbidity of subsequent laparoscopic Nissen fundoplication
INTRODUCTION: Transoral incisionless fundoplication (TIF) has been used for endoscopic treatment of gastroesophageal reflux disease (GERD). Full-thickness polypropylene H-fasteners create a serosa-to-serosa gastroesophageal plication. A certain subset of TIF patients will require subsequent antireflux surgery to achieve adequate reflux control, and it is unknown whether this procedure increases the technical difficulty of laparoscopic Nissen fundoplication… Read more »
Transoral Fundoplication vs. Proton Pump Inhibitor Therapy For Treatment of Chronic Gastroesophageal Reflux: Short-term Results From a Multicenter, Randomized, Open Label Clinical Trial
BACKGROUND & AIM: Transoral fundoplication (TF) has previously been shown to be a safe and effective treatment alternative for a selected gastroesophageal reflux disease (GERD) patient population. The aim of this prospective, multicenter, open-label, randomized study was to compare the safety and efficacy of the TF procedure against maximum dose PPI in controlling the chronic… Read more »