Prospective, Randomized Ex Vivo Trial to Assess the Ideal Stapling Site for Endoscopic Fundoplication with Medigus Ultrasonic Surgical Endostapler

Background and Aims. Endoscopic fundoplication is an emerging technique for the treatment of gastroesophageal reflux disease (GERD). The aim of this study is to determine the ideal position of the staples in relation to gastroesophageal junction (GEJ). Methods. Ten endoscopic fundoplication procedur...

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Main Authors: Tae-Geun Gweon, Kai Matthes
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2016/3161738
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author Tae-Geun Gweon
Kai Matthes
author_facet Tae-Geun Gweon
Kai Matthes
author_sort Tae-Geun Gweon
collection DOAJ
description Background and Aims. Endoscopic fundoplication is an emerging technique for the treatment of gastroesophageal reflux disease (GERD). The aim of this study is to determine the ideal position of the staples in relation to gastroesophageal junction (GEJ). Methods. Ten endoscopic fundoplication procedures were performed in each group using fresh ex vivo porcine stomachs: Group A: 2 staples each at 3 cm above the GEJ and 180° apart; Group B: 2 staples at 3 cm and 90° apart; Group C: 2 staples at 4 cm and 180° apart; Group D: 3 staples at 3 cm with 90° between each staple (180° total). After the procedure, the stomach was gradually filled with water. Gastric yield pressure (GYP) was determined by detection of reflux of the water in esophagus or by rupture of staples. Results. Mean increase of GYPs (±SD) after the procedure was as follows: Group A: 16.9±8.7; Group B: 8.1±7.9; Group C: 12.2±9.4; Group D: 22.7±13.3. GYP in Group A and Group D was higher than Group B (p=0.03 and p=0.01, resp.). Conclusions. We recommend the placement of 3 staples at 3 cm distance from the GEJ, which resulted in the highest increase of GYP.
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spelling doaj-art-3a7be4600645474aa9d77edcd323813a2025-02-03T01:00:24ZengWileyGastroenterology Research and Practice1687-61211687-630X2016-01-01201610.1155/2016/31617383161738Prospective, Randomized Ex Vivo Trial to Assess the Ideal Stapling Site for Endoscopic Fundoplication with Medigus Ultrasonic Surgical EndostaplerTae-Geun Gweon0Kai Matthes1Division of Gastroenterology, Children’s Hospital Boston, Harvard Medical School, Boston, MA 02115, USADivision of Gastroenterology, Children’s Hospital Boston, Harvard Medical School, Boston, MA 02115, USABackground and Aims. Endoscopic fundoplication is an emerging technique for the treatment of gastroesophageal reflux disease (GERD). The aim of this study is to determine the ideal position of the staples in relation to gastroesophageal junction (GEJ). Methods. Ten endoscopic fundoplication procedures were performed in each group using fresh ex vivo porcine stomachs: Group A: 2 staples each at 3 cm above the GEJ and 180° apart; Group B: 2 staples at 3 cm and 90° apart; Group C: 2 staples at 4 cm and 180° apart; Group D: 3 staples at 3 cm with 90° between each staple (180° total). After the procedure, the stomach was gradually filled with water. Gastric yield pressure (GYP) was determined by detection of reflux of the water in esophagus or by rupture of staples. Results. Mean increase of GYPs (±SD) after the procedure was as follows: Group A: 16.9±8.7; Group B: 8.1±7.9; Group C: 12.2±9.4; Group D: 22.7±13.3. GYP in Group A and Group D was higher than Group B (p=0.03 and p=0.01, resp.). Conclusions. We recommend the placement of 3 staples at 3 cm distance from the GEJ, which resulted in the highest increase of GYP.http://dx.doi.org/10.1155/2016/3161738
spellingShingle Tae-Geun Gweon
Kai Matthes
Prospective, Randomized Ex Vivo Trial to Assess the Ideal Stapling Site for Endoscopic Fundoplication with Medigus Ultrasonic Surgical Endostapler
Gastroenterology Research and Practice
title Prospective, Randomized Ex Vivo Trial to Assess the Ideal Stapling Site for Endoscopic Fundoplication with Medigus Ultrasonic Surgical Endostapler
title_full Prospective, Randomized Ex Vivo Trial to Assess the Ideal Stapling Site for Endoscopic Fundoplication with Medigus Ultrasonic Surgical Endostapler
title_fullStr Prospective, Randomized Ex Vivo Trial to Assess the Ideal Stapling Site for Endoscopic Fundoplication with Medigus Ultrasonic Surgical Endostapler
title_full_unstemmed Prospective, Randomized Ex Vivo Trial to Assess the Ideal Stapling Site for Endoscopic Fundoplication with Medigus Ultrasonic Surgical Endostapler
title_short Prospective, Randomized Ex Vivo Trial to Assess the Ideal Stapling Site for Endoscopic Fundoplication with Medigus Ultrasonic Surgical Endostapler
title_sort prospective randomized ex vivo trial to assess the ideal stapling site for endoscopic fundoplication with medigus ultrasonic surgical endostapler
url http://dx.doi.org/10.1155/2016/3161738
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