Endoluminal fundoplication for the treatment of GERD: A preliminary report of a new transoral approach

Abstract

Aim of the study: This is a preliminary report of endoluminal
fundoplication (ELF) for the treatment of GERD. Method: Inclusion
criteria [age 18-80; BMI < 35; Chronic GERD >6 mo;
GERD-health related quality of life score diff ≥ 10 with PPI
dependence; DeMeester > 14.7 (after 14 d without PPI); Deteriorated
GEV Hill grade ≥ 2 or HH (hiatus hernia) < 2 cm;
esophagitis < L.A. (Los Angeles) grade D at time of procedure;
acceptable upper GI; acceptable manometry and no visible
Barrett's esophagus] are used for enrollment of patients in this
protocol. ELF is performed with the use of the EsophyxTM device.
Case presentation: Two male patients 37 and 55-years-old
with chronic GERD underwent ELF under general anesthesia.
Post-procedure period was uneventful and patients were discharged
after 24 hours. Cessation of PPIs one week after the
procedure was not followed by relapse of GERD symptoms.
Conclusion: Current advances in endoscopic treatment of
GERD with the development of alternative to surgery endoluminal
devices recreating the gastroesophageal valve in
a similar pattern as laparoscopic procedures are promising.
According to recent studies, reduction of invasiveness, procedural
time, adverse effects, hospital stay and need for medical
treatment seems to be cost-saving in combination with clinical
effectiveness and improved quality of life.