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A novel endoscopic transgastric fundoplication procedure for gastroesophageal reflux: an initial animal evaluation
R W Jennings1, A W Flake, G Mussan
1Department of Surgery, University of California, San Francisco.
Insights
Researchers developed a new endoscopic transgastric fundoplication technique in pigs to treat gastroesophageal reflux. This minimally invasive approach shows promise for reducing surgical risks compared to traditional open surgery.
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
- Surgical Innovation
Background:
- Gastroesophageal reflux complications are prevalent in both adults and children.
- Current surgical treatments involve open surgery, posing significant risks, especially for high-risk pediatric patients.
- There is a need for less invasive and safer surgical options for fundoplication.
Purpose of the Study:
- To develop and evaluate a novel endoscopic transgastric approach for creating a gastric fundoplication.
- To assess the feasibility and potential benefits of this minimally invasive technique.
- To compare the endoscopic approach with existing open surgical methods.
Main Methods:
- A novel fundoplication technique was developed using an endoscopic transgastric approach in a porcine model.
- The procedure involved creating an esophageal intussusception into the stomach under direct endoscopic visualization.
- A custom stapling device was utilized to plicate the gastric fundus around the esophagus.
Main Results:
- The endoscopic transgastric fundoplication was successfully created in pigs.
- The procedure was technically straightforward and performed under direct vision.
- The approach demonstrated potential for preventing gastroesophageal reflux.
Conclusions:
- The endoscopic transgastric fundoplication represents a novel, minimally invasive alternative to open surgical techniques.
- This approach offers potential advantages in reducing morbidity and mortality associated with fundoplication.
- Further research is warranted to validate the efficacy and long-term outcomes in clinical settings.
Abstract:
Complications of gastroesophageal reflux are common in adults and children. A variety of surgical procedures have been successfully used to treat this condition. All current techniques require open surgery and are associated with significant morbidity and mortality, particularly in the high risk, neurologically damaged child. The authors have developed a novel method of creating a gastric fundoplication using an endoscopic transgastric approach in pigs. The procedure involves the creation of an esophageal intussusception into the stomach under direct vision with an endoscope. The gastric fundus is then plicated around the esophagus using a custom stapling device. The transgastric approach allows creation of a fundoplication, is easily performed, is potentially effective at preventing gastroesophageal reflux, and has the obvious advantages of minimally invasive surgery over open techniques of fundoplication.