The TEMPO Trial at 5 Years: Transoral Fundoplication (TIF 2.0) Is Safe, Durable, and Cost-effective

Background.  Questions remain about the therapeutic durability of transoral incisionless fundoplication (TIF). In this study, clinical outcomes were evaluated at 5 years post-TIF 2.0. Methods. A total of 63 chronic gastroesophageal reflux disease (GERD) sufferers with troublesome symptoms refractory to proton pump inhibitor (PPI) therapy, absent or ≤2 cm hiatal hernia, and abnormal esophageal acid… Read more »

Endoscopic anti-reflux devices (with videos)

BACKGROUND GERD is one of the most common GI diseases, accounting for 7 million annual outpatient visits in the United States.1 Lifestyle modification and medical therapy, including acid-suppressive medications, are first-line treatments for GERD.2,3 In approximately 30% to 40% of patients with GERD, medical therapy provides only partial relief of symptoms.4 Laparoscopic anti-reflux surgery remains… Read more »

Endoscopic Fundoplication: Effectiveness for Controlling Symptoms of Gastroesophageal Reflux Disease

OBJECTIVE: Transoral incisionless fundoplication (TIF) is a completely endoscopic approach to treat gastroesophageal reflux disease (GERD). We previously reported our initial results demonstrating safety and early effectiveness. We now present an updated experience describing outcomes with longer follow-up. METHODS: For a three-year period, TIF procedures were performed on 80 patients. Preoperative workup routinely consisted of… Read more »

Transoral fundoplication offers durable symptom control for chronic GERD: 3-year report from the TEMPO randomized trial with a crossover arm

BACKGROUND: Four randomized controlled trials have demonstrated the short-term efficacy and safety of transoral esophagogastric fundoplication (TF) performed with the EsophyX®device in eliminating troublesome gastroesophageal reflux disease (GERD) symptoms in well-selected patient populations. The aim of this study was to assess the durability of these outcomes at 3 years post-procedure. METHODS: The TF EsophyX versus Medical… 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 »

An Episode Payment Framework for Gastroesophageal Reflux Disease: Symptomatic Gastroesophageal Reflux Disease, Dysplastic and Nondysplastic Barrett’s Esophagus, and Anti-Reflux Surgical and Endoscopic Interventions

Health care currently constitutes approximately 17.4% of the Gross Domestic Product in the United States, with health care spending increasing by 6.2% annually, according to the US Department of Commerce.1,2 Efforts to contain costs include reforms to the overall delivery system, such as Accountable Care Organizations and Patient-Centered Medical Neighborhoods, as well as a variety… Read more »

Laparoscopic Hiatal Hernia Repair in 221 Patients: Outcomes and Experience

BACKGROUND AND OBJECTIVES: Hiatal hernia is a common condition often associated with symptomatic gastroesophageal reflux disease (GERD). The objectives of this study were to examine the efficacy and safety of laparoscopic hiatal hernia repair (LHHR) with biologic mesh to reduce and/or alleviate GERD symptoms and associated hiatal hernia recurrence. METHODS: We retrospectively reviewed consecutive LHHR… Read more »

Transoral Incisionless Fundoplication for Refractory Gastroesophageal Reflux Disease: Where Do We Stand?

Gastroesophageal reflux disease (GERD) is a chronic, progressive, and costly medical condition affecting a substantial proportion of the world population, predominantly the Western population. The available treatment options for patients with refractory GERD symptoms are limited to either laparoscopic surgery with significant sequelae or potentially lifelong, high-dose proton pump inhibitor therapy. The restoration of the… Read more »