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Acta from the EndoFLIP® Symposium.

Silvana Perretta1, Oliver McAnena, Abrie Botha

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Summary
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Laparoscopic fundoplication (LF) for GERD shows high success in expert centers. Intraoperative use of the Functional Lumen Imaging Probe (EndoFLIP) may standardize this surgery and improve patient outcomes.

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Area of Science:

  • Gastroenterology
  • Surgical Technology
  • Medical Devices

Background:

  • Laparoscopic fundoplication (LF) is a common surgical treatment for gastroesophageal reflux disease (GERD).
  • While high-volume centers report excellent outcomes (>90% success), general population data suggests worse results, leading to variability and declining procedure rates.
  • Lack of standardization and objective calibration tools are suspected causes for inconsistent LF outcomes.

Purpose of the Study:

  • To determine if intraoperative use of the Functional Lumen Imaging Probe (EndoFLIP) can standardize LF surgery for GERD.
  • To understand physiological changes in the gastroesophageal junction (GEJ) during fundoplication using EndoFLIP.
  • To objectively profile the characteristics of a normal postoperative GEJ.

Main Methods:

  • Review of EndoFLIP system history and prior studies characterizing the GEJ.
  • Analysis of data from 5 international high-volume centers performing LF with expert surgeons.
  • Utilizing impedance planimetry with EndoFLIP to measure GEJ shape and compliance during surgery.

Main Results:

  • Data from 5 international expert sites were presented at a symposium in Strasbourg.
  • The study aimed to objectively profile normal postoperative GEJ characteristics.
  • Intraoperative EndoFLIP use was explored as a method for standardizing LF.

Conclusions:

  • The Functional Lumen Imaging Probe (EndoFLIP) offers a potential tool for standardizing laparoscopic fundoplication.
  • Objective intraoperative measurement of the gastroesophageal junction may improve surgical consistency and patient outcomes for GERD.
  • Further understanding of GEJ physiology during LF could enhance surgical technique and reduce outcome variability.