Update on Endoscopic Approaches for the Management of Gastroesophageal Reflux Disease

Abstract: Gastroesophageal reflux disease (GERD) is one of the most commonly encountered gastrointestinal diseases in outpatient clinics. Proton pump inhibitors (PPIs) are the cornerstone of the treatment of GERD. However, approximately one-third of patients have suboptimal response to PPIs. The management options in such cases include antireflux surgery or endoscopic antireflux treatments. Antireflux surgery is… Read more »

Massive Caudate Lobe in Laparoscopic Hiatal Hernia Repair: Tying and Wrapping outside the Box

The presence of anatomical obstacles in the limited operative field of laparoscopic hiatal hernia repair (LHHR) creates significant technical difficulties. This case presentation highlights the use of laparoendoscopic approach in these operative situations. This patient is a 60-year-old female with past medical history of diabetes, anxiety, depression, hypertension, hyperlipidemia, hypothyroidism, and psoriasis. She had gastroesophageal… Read more »

pH Scores in Hiatal Repair with Transoral Incisionless Fundoplication

Background and Objectives: Transoral incisionless fundoplication is an alternative to traditional laparoscopic fundoplications. Recently, hiatal hernia repair combined with transoral incisionless fundoplication has become an accepted modification of the original procedure; however, outcomes information, particularly objective pH monitoring, has been sparse. We retrospectively review the subjective and objective outcomes of transoral incisionless fundoplication combined with… Read more »

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 »