Endoscopic GERD therapy: a primer to the transoral incisionless fundoplication procedure.

Abstract Patients with medically refractory gastroesophageal reflux disease (GERD) have the option of surgery but may opt for effective minimally invasive interventions, when available. However, the primary GERD pharmacological therapy, proton pump inhibitors, does not satisfactorily address the pathophysiology of the disease. Moreover, a therapeutic gap exists in those severely symptomatic patients who fail medical… Read more »

Endoscopic foregut surgery and interventions: The future is now. The state-of-the-art and my personal journey

In this paper, I reviewed the emerging field of endoscopic surgery and present data supporting the contention that endoscopy can now be used to treat many foregut diseases that have been traditionally treated surgically. Within each topic, the content will progress as follows: “lessons learned”, “technical considerations” and “future opportunities”. Lessons learned will provide a… Read more »

The Spectrum of Surgical Remediation of Transoral Incisionless Fundoplication-Related Failures

AIM: To evaluate outcomes of surgical remediation for symptomatic or anatomic failure after a transoral incisionless fundoplication (TIF). METHODS: This retrospective study was performed on 11 patients who underwent a remedial operation following TIF failure between June 2011 and September 2016 at the Mayo Clinic in Florida for persistent foregut symptoms. Upper gastrointestinal workup characterized… Read more »

Management options for patients with GERD and persistent symptoms on proton pump inhibitors: recommendations from an expert panel

BACKGROUND: The aim of this study was to assess expert gastroenterologists’ opinion on treatment for distinct gastroesophageal reflux disease (GERD) profiles characterized by proton pump inhibitor (PPI) unresponsive symptoms. METHODS: Fourteen esophagologists applied the RAND/UCLA Appropriateness Method to hypothetical scenarios with previously demonstrated GERD (positive pH-metry or endoscopy) and persistent symptoms despite double-dose PPI therapy… Read more »

Efficacy of transoral incisionless fundoplication for refractory gastroesophageal reflux disease: a systematic review and meta-analysis

BACKGROUND: Given poor symptomatic response rates and rising awareness of the adverse events associated with the long-term use of proton pump inhibitors (PPIs), endoscopic modalities for treatment of refractory gastroesophageal reflux disease (GERD) have become more prominent. The aim of this study was to perform a systematic review and meta-analysis to evaluate feasibility, efficacy, and… Read more »

Trans-oral incisionless fundoplication vs stretta, two recognized endoluminal anti-reflux therapies; a systematic review and meta-analysis

Gastro-oesophageal reflux disease (GORD) is common with a prevalence of 10-20% in the Western World. During the last two decades, amongst introduced several endo-luminal techniques, evidence has emerged about the efficacy and safety of two treatment modalities for GORD; ‘Stretta’ procedure and trans-oral incisionless fundoplication (TIF)’ or EsophyX. Author in this study aim to conduct… Read more »

Efficacy of Laparoscopic Nissen Fundoplication vs Transoral Incisionless Fundoplication or Proton Pump Inhibitors in Patients With Gastroesophageal Reflux Disease: A Systematic Review and Network Meta-analysis

BACKGROUND & AIMS: The effects of transoral incisionless fundoplication (TIF) and laparoscopic Nissen fundoplication (LNF) have been compared with those of proton pump inhibitors (PPIs) or a sham procedure in patients with gastroesophageal reflux disease (GERD), but there has been no direct comparison of TIF vs LNF. We performed a systematic review and network meta-analysis… Read more »

Endoscopic fundoplication: patient selection and technique

Gastroesophageal reflux disease (GERD) is a common condition that places a significant burden on the healthcare system. Additionally, there have been concerns raised about potential risks of long-term proton pump inhibitors. Laparoscopic anti-reflux surgery is currently the gold standard option for patients when surgery is planned. However, there continues to be interest in an endoscopic,… Read more »

Efficacy of transoral incisionless fundoplication (TIF) for the treatment of GERD: a systematic review with meta-analysis

BACKGROUND: The efficacy of transoral incisionless fundoplication (TIF) performed with the EsophyX device (Redmond, Washington, USA) and its long-term outcomes in gastresophageal reflux disease (GERD) are debated. We, therefore, performed a systematic review with meta-analysis of studies evaluating the role of TIF in GERD. METHODS: A systematic search of EMBASE, SCOPUS, PubMed, and the Cochrane… Read more »