Transgastric-Assisted Endoscopic Fundoplication

Konstantinos Spaniolas,Thadeus L Trus,Richard I Rothstein

doi:10.1155/2013/280628

Konstantinos Spaniolas, Thadeus L Trus + Show 1 more

Open Access

https://doi.org/10.1155/2013/280628

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Abstract

Gastroesophageal reflux disease (GERD) is a common entity in the United States. Surgical fundoplication can be performed safely with well-established long-term results. In selected patients with GERD, endoluminal therapy has a potential role. We report on a patient with recurrent GERD after two prior fundoplications who wished to pursue endoscopic treatment. The presence of a gastrostomy tube allowed for the performance of a transgastric-assisted endoluminal fundoplication using the EndoCinch (TM) device and standard pediatric laparoscopic instruments. Symptomatic relief of GERD with EndoCinch (TM) is common but the long-term outcomes are limited. Nevertheless, the EndoCinch (TM) device remains a method for endoscopic suturing in certain settings. In patients with gastrostomy access, the use of laparoscopic instruments may further enable the performance of advanced endoscopic therapies.

Highlights

Gastroesophageal reflux disease (GERD) represents a common problem in the United States with an estimated incidence of 28% [1]
While long-term results for most approved devices are not yet available, endoluminal therapies for GERD represent an alternative for the management of this disease
Endoluminal therapies have emerged as a treatment option for GERD

Summary

Background

Gastroesophageal reflux disease (GERD) represents a common problem in the United States with an estimated incidence of 28% [1]. The development of endoluminal therapies for GERD has emerged in an effort to transorally reproduce the anatomic and physiologic results of fundoplication. Multiple devices have been developed, and a few have been introduced in clinical practice. While long-term results for most approved devices are not yet available, endoluminal therapies for GERD represent an alternative for the management of this disease. The EndoCinch (TM) device (Bard Endoscopic Technologies, Murray Hill, NJ, USA) was approved for clinical use in 2000. It is placed over a standard endoscope and inserted at the level of the gastroesophageal junction through an overtube. We report on a case where transgastric access was used to optimize application of the EndoCinch (TM) device

Case Report

Findings

Discussion