Endoscopic full-thickness plication for the treatment of GERD by application of multiple Plicator implants: a multicenter study (with video)

Electrical Stimulation Therapy for Gastroesophageal Reflux Disease

“…Less-invasive endoscopic suturing devices as the Endocinch (Bard Endoscopic Technologies, Nurray Hill, NJ, USA), Plicator (NDO Surgical Inc., Mansfield, MA, USA) and the EsophyX (EndoGastric Solutions, Inc., Silver Spring, MD, USA) have tried to mimic the effects of conventional anti-reflux surgery by the creation of gastroesophageal plications. [29][30][31] Although early improvements in symptoms and medication use were reported in several trials, clinical efficacy or durability to the level of conventional anti-reflux surgery have not been met. 32 The Enteryx procedure aimed to increase sphincter competence by injection of sponge-like material into the LES.…”

“…Currently, 18 patients have completed 3-month follow-up and 14 patients 6-month follow-up. Interim results showed a positive ef- fect on symptoms: GERD-HRQL median (IQR) score was 4 (2-11) at 3 months and 5 (4-9) at 6 months, respectively with P < 0.001 and P < 0.01 when compared to baseline score off PPI (31 [25][26][27][28][29][30][31][32][33][34][35][36][37]). Furthermore, acid exposure time decreased from 11.3% (9.0-15.5%) at baseline to 3.3% (2.5-9.1%) at 3 months and to 2.6% (1.8-5.4%) at 6 months (Fig.…”

Do Endoscopic Antireflux Procedures Fit in the Current Treatment Paradigm of Gastroesophageal Reflux Disease?

“…In a multicenter investigation, 41 patients with two or more plications were evaluated with 6 month follow up data. While clinical symptoms improved, median %AET only decreased from 11 to 9, with only 31% achieving complete normalization of % AET 29 .…”

Endoscopic Treatment of Refractory Gastroesohageal Reflux Disease

“…The QOL of patients were improved by more than 50%, and the use of PPI was significantly decreased in 50% to 80%, accompanied with decreased esophageal acid exposure 28. On the contrary to these achievements, normalization of pH was observed in only 14% to 30% of the patients, and LES pressure measured by manometry was generally unchanged 25-28. Fever, abdominal pain, pharyngitis were reported.…”

“…The helical tissue retractor retracts the the stomach wall, approximately 1.5 cm below the cardia, then the instruments arms are closed, creating a serosa-serosa placation 27. The QOL of patients were improved by more than 50%, and the use of PPI was significantly decreased in 50% to 80%, accompanied with decreased esophageal acid exposure 28. On the contrary to these achievements, normalization of pH was observed in only 14% to 30% of the patients, and LES pressure measured by manometry was generally unchanged 25-28.…”