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CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(09): E1120-E1125
DOI: 10.1055/a-0603-3693
Original article
Owner and Copyright © Georg Thieme Verlag KG 2018

Endoscopic augmentation of gastroesophageal junction using a full-thickness endoscopic suturing device

Jimin Han
1   Department of Internal Medicine, Catholic University of Daegu School of Medicine Daegu, South Korea
,
Matthew Chin
2   H. H. Chao Comprehensive Digestive Disease Center, University of California Irvine Medical Center, Orange, California, USA
,
Kyle J. Fortinsky
2   H. H. Chao Comprehensive Digestive Disease Center, University of California Irvine Medical Center, Orange, California, USA
,
Reem Sharaiha
3   Weill Cornell Medicine, Division of Gastroenterology and Hepatology, Department of Medicine New York, New York, USA
,
Christopher J. Gostout
4   Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
,
Kenneth J. Chang
2   H. H. Chao Comprehensive Digestive Disease Center, University of California Irvine Medical Center, Orange, California, USA
› Author Affiliations
Further Information

Publication History

submitted 08 February 2018

accepted after revision 03 April 2018

Publication Date:
11 September 2018 (online)

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Abstract

Background and study aims This preliminary study was conducted to determine the feasibility and safety of endoscopic augmentation of the gastroesophageal junction (GEJ) using the Apollo OverStitch endoscopic suturing system in patients with gastroesophageal reflux disease (GERD) symptoms.

Patients and methods Endoscopic augmentation of GEJ was performed on 10 consecutive patients and the data were analyzed retrospectively. Using a double-channel gastroscope affixed to the endoscopic suturing platform, interrupted sutures were placed on the gastric side of the GEJ in 2 layers in order to create a narrowed and elongated GEJ.

Results Technical success was achieved in all patients, including those with a history of previous antireflux procedures (n = 7) and those with a hiatal hernia (n = 6). The median follow-up duration was 5 mo (range: 2 – 12). The median pre-procedure GERD-Health Related Quality of Life Questionnaire improved from 20 (range: 11 – 45) to a post-procedure score of 6 (range: 3 – 25) (P = 0.001). The median duration of GERD symptom improvement after the procedure was 1 mo (range: 0.5 – 4). Adverse events were limited to 1 patient who developed nausea and vomiting, which was self-limited.

Conclusions The use of a novel endoscopic suturing technique for the treatment of GERD is feasible and safe. The procedure resulted in short-term GERD symptom improvement. Further prospective studies using refined techniques are currently underway to improve durability and to prove efficacy.

Comment to this article:

Endoscopy International Open – recently publishedEndoscopy 2018; 50(10): 1038-1038
DOI: 10.1055/a-0666-5003

 

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