Endoluminal gastroplasty: a new treatment for gastroesophageal reflux disease

Initial studies demonstrate that EndoCinch is safe and may be an effective outpatient procedure. Symptom improvement, reduction in medication requirements, and ultrasound evidence of muscle hypertrophy are encouraging. The durability of these benefits remains in question. Seventeen percent of patients require a repeat gastroplication to achieve a satisfactory result and some elect to undergo laparoscopic Nissen fundoplication. Additional investigations are required to assess the number and location of the plications for optimal patient outcome. Prospective randomized studies comparing ELGP to medical and surgical treatments of GERD may be appropriate after device refinements. Of additional importance is the possibility of a cure with an ELGP. Patients who are self-medicated or noncompliant often are willing to seek consultation if a noninvasive curative procedure is available. One third of these patients have advanced disease and are treated best with surgery rather than an ELGP; thus, surgeons should be involved with ELGP for GERD control.