Transoral mucosal excision sutured gastroplasty: a pilot study for GERD and obesity with two-year follow-up.
Bottom Line: An outpatient transoral endoscopic procedure for gastroesophageal reflux disease (GERD) and obesity would be appealing if safe, effective, and durable.The subsequent 5 subjects had a successfully completed procedure.The initial human clinical experience showed promising results for effective and safe GERD and obesity therapy.
Affiliation: Saint George University Teaching Hospital, Szekesfehervar, Hungary.Show MeSH
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Mentions: The suture device was introduced over a guidewire and positioned for suturing within excision #3 (Figure 4). The sutures are full thickness if placed within the excision bed and partially close the GEJ at the greater curvature side. A vacuum is applied and after suture application the position of the suture device is checked (Supplemental Data Figure S8). The device is then rotated to the first excision bed and the process is repeated (Supplemental Data Figure S9). The suction is discontinued, the sutures are inspected (Supplemental Data Figure S10) and the suture device is removed from the patient. The sutures are organized outside the patients’ mouth and the distal suture strands are placed into the knotter and between the plug and sleeve (Supplemental Data Figure S11). The knotter is run over the sutures under slight tension into the esophagus and the 6 mm endoscope is introduced for visualization (Figures 5 and Supplemental Data Figure S12). The endoscope is retroflexed in the stomach as the sutures are tightened to the tissue to assure tissue apposition (Supplemental Data Figure S13). This is repeated with the more proximal suture strands and the completed GERD (Figure 6) and obesity procedures (Figure 7) are shown.
Affiliation: Saint George University Teaching Hospital, Szekesfehervar, Hungary.