BACKGROUND: The functional lumen imaging probe (FLIP) uses impedance planimetry to measure the geometry of a distensible organ. The purpose of this study was to evaluate FLIP as a method to determine structural changes at the gastroesophageal junction (GEJ) following transoral incisionless fundoplication (TIF) and compare these findings with the accepted methods of esophageal testing. METHODS: Two different approaches (TIF1.0 and 2.0) using the EsophyX device were performed in six and five animals, respectively. Three dogs underwent a sham procedure. FLIP measurements were performed pre- and post-procedure and at 2-week follow-up. Upper endoscopy, manometry, and 48-h pH testing were also performed at each time point. FLIP was performed in ten patients before and 3 months after TIF. RESULTS: Following TIF procedures, there was a significant decrease in cross-sectional area (CSA) of GEJ compared to baseline; however, the CSA of both groups returned to baseline at 2-week follow-up. The FLIP results were supported with pH testing and correlated highly with both measures of GEJ structural integrity (LES and cardia circumference). Following TIF in humans, there was a decrease in GEJ distensibility compared to baseline that persisted to the 3-month evaluation. CONCLUSION: FLIP is able to measure and display changes in tissue distensibility at the GEJ, and results correlate with established methods of testing. FLIP may represent a single testing modality by which to diagnose GERD and evaluate the outcome after antireflux surgery.
- Gastroesophageal reflux
- Functional lumen imaging probe
- Endolumenal fundoplication
- Antireflux surgery
- GASTROESOPHAGEAL-REFLUX DISEASE
- CANINE MODEL
Hoppo, T., McMahon, B. P., Witteman, B. P., Kraemer, S. J., O'Rourke, R. W., Gravesen, F., Bouvy, N. D., & Jobe, B. A. (2011). Functional lumen imaging probe to assess geometric changes in the esophagogastric junction following endolumenal fundoplication. Journal of Gastrointestinal Surgery, 15(7), 1112-1120. https://doi.org/10.1007/s11605-011-1562-2