Initial Experience with New Intraluminal Devices for GERD Barrett’s Esophagus and Obesity

Filipi, Charles J.; Stadlhuber, Rudolf J.

doi:10.1007/s11605-009-1027-z

Cited by 7 publications

(4 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They are classified into three categories. The first is a method to generate plication on cardia [166][167][168][169][170]. The second involves alteration of muscle layer on LES [171], and the third involves insertion of foreign bodies into LES [172,173].…”

Section: Cq: Is Laparoscopic Fundoplication Useful Compared With Openmentioning

confidence: 99%

Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015

et al. 2016

View full text Add to dashboard Cite

As an increase in gastroesophageal reflux disease (GERD) has been reported in Japan, and public interest in GERD has been increasing, the Japanese Society of Gastroenterology published the Evidence-based Clinical Practice Guidelines for GERD (1st edition) in 2009. Six years have passed since its publication, and there have been a large number of reports in Japan concerning the epidemiology, pathophysiology, treatment, and Barrett's esophagus during this period. By incorporating the contents of these reports, the guidelines were completely revised, and a new edition was published in October 2015. The revised edition consists of eight items: epidemiology, pathophysiology, diagnosis, internal treatment, surgical treatment, esophagitis after surgery of the upper gastrointestinal tract, extraesophageal symptoms, and Barrett's esophagus. This paper summarizes these guidelines, particularly the parts related to the treatment for GERD. In the present revision, aggressive proton pump inhibitor (PPI) maintenance therapy is recommended for severe erosive GERD, and on-demand therapy or continuous maintenance therapy is recommended for mild erosive GERD or PPI-responsive non-erosive GERD. Moreover, PPI-resistant GERD (insufficient symptomatic improvement and/or esophageal mucosal break persisting despite the administration of PPI at a standard dose for 8 weeks) is defined, and a standard-dose PPI twice a day, change in PPI, change in the PPI timing of dosing, addition of a prokinetic drug, addition of rikkunshito (traditional Japanese herbal medicine), and addition of histamine H2-receptor antagonist are recommended for its treatment. If no improvement is observed even after these treatments, pathophysiological evaluation with esophageal impedancepH monitoring or esophageal manometry at an expert facility for diseases of the esophagus is recommended.

show abstract

Section: Cq: Is Laparoscopic Fundoplication Useful Compared With Openmentioning

confidence: 99%

Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Results from ex vivo and in vivo animal experiments are available. 12 In ex vivo experiments focusing on excision capsule trough size and knife blade depth, reliable mucosal excision was proven (n = 114). The injection needle positions allowed consistent submucosal injection and successful excision overlap in 99.1% of 124 experiments.…”

Section: Intragastric Balloonsmentioning

confidence: 99%

“…10,11 We previously reported the development of a transoral endoscopic device that creates a full-thickness gastroplasty for both GERD and morbid obesity. 12 Herein we report new results with mucosal excision and suturing for GERD and obesity using new-generation excision and suturing devices.…”

Section: Introductionmentioning

confidence: 99%

Mucosal Excision and Suturing for Obesity and GERD

et al. 2013

Self Cite

View full text Add to dashboard Cite

show abstract

“…We have demonstrated in the animal laboratory that this is possible. 7 The purpose of this pilot project was to demonstrate feasibility and safety of the procedure and if possible preliminary effectiveness.…”

Section: Introductionmentioning

confidence: 99%

Transoral Mucosal Excision Sutured Gastroplasty

Légner¹,

Altorjay²,

Juhasz³

et al. 2014

Surg Innov

View full text Add to dashboard Cite

Introduction. An outpatient transoral endoscopic procedure for gastroesophageal reflux disease (GERD) and obesity would be appealing if safe, effective, and durable. We present the first in human experience with a new system. Methods. Eight patients with GERD (3) and obesity (5) were selected according to a preapproved study protocol. All GERD patients had preprocedure manometry and pH monitoring to document GERD as well as quality of life and symptom questionnaires. Obese patients (body mass index >35) underwent a psychological evaluation and tests for comorbidities. Under general anesthesia, a procedure was performed at the gastroesophageal junction including mucosal excision, suturing of the excision beds for apposition, and suture knotting. Results. One patient with micrognathia could not undergo the required preprocedural passage of a 60 F dilator and was excluded. The first 2 GERD patients had incomplete procedures due to instrument malfunction. The subsequent 5 subjects had a successfully completed procedure. Four patients were treated for obesity and had an average excess weight loss of 30.3% at 2-year follow-up. Of these patients, one had an 8-mm outlet at the end of the procedure recognized on video review—a correctable error—and another vomited multiple times postoperatively and loosened the gastroplasty sutures. The treated GERD patient had resolution of reflux-related symptoms and is off all antisecretory medications at 2-year follow-up. Her DeMeester score was 8.9 at 24 months. Conclusion. The initial human clinical experience showed promising results for effective and safe GERD and obesity therapy.

show abstract

Initial Experience with New Intraluminal Devices for GERD Barrett’s Esophagus and Obesity

Abstract: The results demonstrate feasibility, reliability, and safety for gastric and esophageal mucosal excision. Suturing reliability improved and further studies will be performed to finalize the instrument designs, the operative techniques, and the other device applications.

Cited by 7 publications

References 21 publications

Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015

Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015

Mucosal Excision and Suturing for Obesity and GERD

Transoral Mucosal Excision Sutured Gastroplasty

Contact Info

Product

Resources

About