Transoral incisionless fundoplication for the treatment of gastroesophageal reflux disease

Abstract

Gastroesophageal reflux disease (GERD) is a common and costly chronic medical condition affecting millions of patients. It is associated with substantial morbidity and negatively impacts quality of life. Reflux of gastric contents into the esophagus damages the esophageal mucosa and is associated with conditions including esophagitis and esophageal stricture. While GERD is most commonly seen in Western populations, changes in dietary patterns and the global increase in obesity have led to a pronounced increase in its prevalence worldwide. Medical and surgical GERD therapies are costly and pose considerable side effects, leading many to pursue effective endoscopic treatment options. Transoral incisionless fundoplication is an endoluminal procedure that offers patients a minimally invasive treatment option with the potential to eliminate the need for medical acid suppression with a low risk of side effects.

Keywords::

• endoluminal surgery
• endoluminal therapy
• esophagitis
• EsophyX™
• gastroesophageal reflux disease
• transoral incisionless fundoplication

Financial & competing interests disclosure

K Reavis and K Perry are consultants for EndoGastric Solutions Inc. Angeline Carlson from Data Intelligence Consultants LLC provided content support. Data Intelligence Consultants, LLC, Eden Prairie, MN, USA provided editorial assistance with this manuscript, which has been supported by funding from EndoGastric Solutions Inc., Redmond, WA, USA. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Gastroesophageal reflux disease is a common and costly chronic condition affecting a substantial proportion of the world’s population.

• Until recently, available treatment options offered limited choices for patients with inadequately controlled gastroesophageal reflux disease symptoms – potentially lifelong, high-dose proton pump inhibitors therapy or laparoscopic surgery with significant sequelae.

• Transoral incisionless fundoplication offers an endoscopic alternative to laparoscopic fundoplication for patients with minimal anatomic changes in the gastroesophageal junction.

• Transoral incisionless fundoplication surgery is a safe, well-tolerated and effective treatment that has yielded significant symptomatic improvement in patients with medically refractory gastroesophageal reflux disease symptoms.

• Studies in the USA using the transoral incisionless fundoplication procedure have demonstrated significantly improved objective and subjective outcomes in up to 70% of patients with proton pump inhibitor-resistant symptoms.

Notes