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The Angelchik antireflux prosthesis.

M Deitel, S S Basi, R Ilves

    Canadian Journal of Surgery. Journal Canadien De Chirurgie
    |March 1, 1985
    PubMed
    Summary
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    This study introduces a novel silicone collar procedure for refractory reflux in high-risk patients. The minimally invasive approach significantly improved symptoms and esophageal function, with no device migration observed.

    Area of Science:

    • Gastroenterology
    • Surgical Innovation
    • Medical Device Technology

    Background:

    • Refractory gastroesophageal reflux disease (GERD) poses challenges in high-risk patients unsuitable for standard antireflux surgery.
    • Hiatal hernias are frequently associated with symptomatic reflux.
    • Previous bariatric surgery can complicate antireflux treatment options.

    Purpose of the Study:

    • To evaluate the safety and efficacy of a novel silicone collar device for treating symptomatic, refractory GERD.
    • To assess the impact of this minimally invasive procedure on patient symptoms and objective reflux parameters.

    Main Methods:

    • Eight patients with refractory GERD, unsuitable for standard procedures, underwent implantation of a silicone collar around the cardio-esophageal junction.
    • Preoperative and postoperative assessments included barium swallow, endoscopy, manometry, and Bernstein testing.

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  • Follow-up ranged from 17 to 48 months.

    • Main Results:

    • A significant improvement (p < 0.01) was observed in patient symptoms, endoscopic findings, and lower esophageal sphincter pressures postoperatively.
    • The mean operating time was 51 minutes, including other concurrent surgical procedures.
    • No instances of prosthesis migration were reported during the follow-up period.

    Conclusions:

    • The silicone collar procedure offers a safe and effective minimally invasive option for managing refractory GERD in high-risk patient populations.
    • This technique demonstrates significant symptomatic and physiological benefits for patients with GERD and associated hiatal hernias.
    • The device shows promising durability and safety, with no migration complications observed.