Peds: Improving functional esophageal surgery with a smart bougie: endoflip.

[Guest guest]

Medline Abstract

Improving functional esophageal surgery with a " smart " bougie: endoflip.

S Perretta, B Dallemagne, B McMahon, J D'Agostino, and J Marescaux

Suhttp://highwire.stanford.edu/cgi/medline/pmid;21437739rg Endosc,

March 25, 2011;

.

Index

Full text via Infotrieve

Alert me when cited

Find more like this

 

IRCAD-EITS,

Department of Digestive and Endocrine Surgery, University of Strasbourg,

1 Place de l'hopital, 67091, Strasbourg Cedex, France,

Silvana.perretta@....

Download to Citation Manager

Alert me when this article is cited

PubMed Citation

Related Articles in PubMed

Order Full text via Infotrieve

BACKGROUND: An emerging imaging tool, the functional lumen imaging

probe (Endoflip; Crospon Ltd, Galway, Ireland), provides a real-time

measurement of esophagogastric junction (EGJ) capacity and diameter,

which would be of particular interest in functional esophageal surgery

such as Heller myotomy and antireflux procedures. This study aimed to

demonstrate the intraoperative use of endoflip in the treatment of

achalasia and gastroesophageal reflux disease (GERD). METHODS: In the

first case, Heller myotomy was performed under endopflip guidance, for

persistent dysphagia after failed endoscopic dilatation. In the second

case, the endoflip was used to calibrate a Nissen fundoplication. With

the patient under general anesthesia, the endoflip catheter was inserted

orally and positioned to straddle the EGJ. At each stage of the

procedure, the balloon was inflated by liquid filling at 40-30�ml/min.

Live diameter data, cross-sectional area (CSA), and balloon pressure

were displayed on the system at all times. RESULTS: Before the myotomy,

the pressure in the balloon rose to 15�mm�Hg at a CSA of 25�mm(2),

indicating that the EGJ is rigid and tight. After the myotomy, the

pressure rose to 8�mm�Hg, and the CSA opened to 34�mm(2), indicating

that the EGJ was now very compliant and flaccid. After the Dor

fundoplication, the junction became less compliant, but it could open at

its narrowest point to 35�mm(2) at a pressure of 20�mm�Hg, suggesting

that the EGJ was tighter but not as rigid as before. The second part of

the video demonstrates that the Endoflip acted as a " smart bougie, "

evaluating the orientation and position of a properly constructed floppy

Nissen. CONCLUSIONS: The endoflip provides a system in which physiology

and anatomy are represented dynamically in the same image. This " smart

bougie " could be integrated into the surgical routine to improve outcome

and to facilitate surgical training and the learning curve in

esophageal functional surgery.

PMID: 21437739

  California Collegiate Shooting Sports 4-H All-Star Advisor to the most

awesome  kids of Amador County!