Endoscopic suturing for gastroesophageal reflux disease: clinical outcome with the Bard EndoCinch

From a review of the single peer reviewed published report and the brief preliminary studies presented in abstract form, the BARD EndoCinch procedure seems safe and demonstrates an acceptable efficacy for symptom control during short-term follow-up. Most patients (about 2 out of 3) do well with improvement of GERD symptoms during the first post-procedural year. This benefit may wane over time. Objective benefit is lacking with the minority of treated individuals achieving normalization of 24-hour total acid exposure, and no significant effect has been seen in healing of esophagitis. This may focus the treatment towards that group of GERD patients with mild or non-erosive disease. The authors have no information that the endoscopic therapy could prevent reflux-related complications, and long-term data is awaited from accumulated clinical experience to establish the maintenance profile of this novel treatment. The outcomes from the sham trial, and long-term follow-up data will help to define the role of this anti-reflux therapy. The authors need additional studies to define the effect of endoluminal plication on the function of the lower esophageal sphincter to optimize its benefit for patients.