Abstract
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.
Original language | English |
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Pages (from-to) | 1112-1120 |
Number of pages | 9 |
Journal | Journal of Gastrointestinal Surgery |
Volume | 15 |
Issue number | 7 |
DOIs | |
Publication status | Published - Jul 2011 |
Keywords
- Gastroesophageal reflux
- Functional lumen imaging probe
- Endolumenal fundoplication
- Antireflux surgery
- GASTROESOPHAGEAL-REFLUX DISEASE
- CANINE MODEL
- SPHINCTER
- SURGERY
- DEVICE
- VALVE
- GERD