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The EndoFLIP™ System Allows a Tailored Peroral Endoscopic Myotomy (POEM) for Achalasia

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Innovative Endoscopic and Surgical Technology in the GI Tract

Abstract

The Endoluminal Functional Lumen Imaging Probe (EndoFLIP™) is a balloon-based catheter that measures intraoperatively the cross-sectional area (CSA) and distensibility of any sphincter using impedance planimetry technology. This “smart bougie” has been quickly identified as an ideal tool for ensuring an adequate myotomy during peroral endoscopic myotomy (POEM) for the treatment of achalasia. EndoFLIP™ offers the possibility to assess the extension of the dissection real time, tailoring the myotomy, minimizing the risk of residual or recurrent dysphagia, and preventing the risk of gastroesophageal reflux disease.

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References

  1. Inoue H, Minami H, Kobayashi Y, Sato Y, Kaga M, Suzuki M, et al. Peroral endoscopic myotomy (POEM) for esophageal achalasia. Endoscopy. 2010;42(04):265–71.

    Article  CAS  Google Scholar 

  2. Parsa N, Khashab MA. POEM in the treatment of esophageal disorders. Curr Treat Options Gastroenterol. 2018;16(1):27–40.

    Article  Google Scholar 

  3. Von Renteln D, Fuchs KH, Fockens P, Bauerfeind P, Vassiliou MC, Werner YB, et al. Peroral endoscopic myotomy for the treatment of achalasia: an international prospective multicenter study. Gastroenterology. 2013;145(2):309–11. e3.

    Article  Google Scholar 

  4. Teitelbaum EN, Soper NJ, Santos BF, Arafat FO, Pandolfino JE, Kahrilas PJ, et al. Symptomatic and physiologic outcomes one year after peroral esophageal myotomy (POEM) for treatment of achalasia. Surg Endosc. 2014;28(12):3359–65.

    Article  Google Scholar 

  5. Inoue H, Sato H, Ikeda H, Onimaru M, Sato C, Minami H, et al. Per-oral endoscopic myotomy: a series of 500 patients. J Am Coll Surg. 2015;221(2):256–64.

    Article  Google Scholar 

  6. Sharata AM, Dunst CM, Pescarus R, Shlomovitz E, Wille AJ, Reavis KM, et al. Peroral endoscopic myotomy (POEM) for esophageal primary motility disorders: analysis of 100 consecutive patients. J Gastrointest Surg. 2015;19(1):161–70.

    Article  Google Scholar 

  7. Miller LS, Vegesna AK, Brasseur JG, Braverman AS, Ruggieri MR. The esophagogastric junction. Ann N Y Acad Sci. 2011;1232:323.

    Article  Google Scholar 

  8. Mohan BP, Ofosu A, Chandan S, Ramai D, Khan SR, Ponnada S, et al. Anterior versus posterior approach in peroral endoscopic myotomy (POEM): a systematic review and meta-analysis. Endoscopy. 2020;52(04):251–8.

    Article  Google Scholar 

  9. Li C, Gong A, Zhang J, Duan Z, Ge L, Xia N, et al. Clinical outcomes and safety of partial full-thickness myotomy versus circular muscle myotomy in peroral endoscopic myotomy for achalasia patients. Gastroenterol Res Pract. 2017;2017:2676513.

    PubMed  PubMed Central  Google Scholar 

  10. Schlottmann F, Luckett DJ, Fine J, Shaheen NJ, Patti MG. Laparoscopic Heller myotomy versus peroral endoscopic myotomy (POEM) for achalasia: a systematic review and meta-analysis. Ann Surg. 2018;267(3):451–60.

    Article  Google Scholar 

  11. Swanstrom LL, Kurian A, Dunst CM, Sharata A, Bhayani N, Rieder E. Long-term outcomes of an endoscopic myotomy for achalasia: the POEM procedure. Ann Surg. 2012;256(4):659–67.

    Article  Google Scholar 

  12. Teitelbaum EN, Dunst CM, Reavis KM, Sharata AM, Ward MA, DeMeester SR, et al. Clinical outcomes five years after POEM for treatment of primary esophageal motility disorders. Surg Endosc. 2018;32(1):421–7.

    Article  Google Scholar 

  13. Pandolfino JE, Kwiatek MA, Nealis T, Bulsiewicz W, Post J, Kahrilas PJ. Achalasia: a new clinically relevant classification by high-resolution manometry. Gastroenterology. 2008;135(5):1526–33.

    Article  Google Scholar 

  14. Triadafilopoulos G, Boeckxstaens G, Gullo R, Patti M, Pandolfino JE, Kahrilas PJ, et al. The Kagoshima consensus on esophageal achalasia. Dis Esophagus. 2012;25(4):337–48.

    Article  CAS  Google Scholar 

  15. Khan MA, Kumbhari V, Ngamruengphong S, Ismail A, Chen Y-I, Chavez YH, et al. Is POEM the answer for management of spastic esophageal disorders? A systematic review and meta-analysis. Dig Dis Sci. 2017;62(1):35–44.

    Article  Google Scholar 

  16. Kumbhari V, Tieu AH, Onimaru M, El Zein MH, Teitelbaum EN, Ujiki MB, et al. Peroral endoscopic myotomy (POEM) vs laparoscopic Heller myotomy (LHM) for the treatment of Type III achalasia in 75 patients: a multicenter comparative study. Endosc Int Open. 2015;3(3):E195.

    Article  Google Scholar 

  17. Barret M, Guillaumot M-A, Leandri C, Leblanc S, Coriat R, Belle A, et al. Intraoperative high-resolution esophageal manometry during peroral endoscopic myotomy. Sci Rep. 2020;10(1):1–6.

    Article  Google Scholar 

  18. Grimes KL, Bechara R, Shimamura Y, Ikeda H, Inoue H. Gastric myotomy length affects severity but not rate of post-procedure reflux: 3-year follow-up of a prospective randomized controlled trial of double-scope per-oral endoscopic myotomy (POEM) for esophageal achalasia. Surg Endosc. 2020;34(7):2963–8.

    Article  Google Scholar 

  19. Ilczyszyn A, Botha A. Feasibility of esophagogastric junction distensibility measurement during Nissen fundoplication. Dis Esophagus. 2014;27(7):637–44.

    Article  CAS  Google Scholar 

  20. Kim MP, Meisenbach LM, Chan EY. Tailored fundoplication with endoluminal functional lumen imaging probe allows for successful minimally invasive hiatal hernia repair. Surg Laparosc Endosc Percutan Tech. 2018;28(3):178–82.

    Article  Google Scholar 

  21. Su B, Novak S, Callahan ZM, Kuchta K, Carbray J, Ujiki MB. Using impedance planimetry (EndoFLIP™) in the operating room to assess gastroesophageal junction distensibility and predict patient outcomes following fundoplication. Surg Endosc. 2020;34(4):1761–8.

    Article  Google Scholar 

  22. DeHaan RK, Frelich MJ, Gould JC. Intraoperative assessment of esophagogastric junction distensibility during laparoscopic Heller myotomy. Surg Laparosc Endosc Percutan Tech. 2016;26(2):137–40.

    Article  Google Scholar 

  23. Rieder E, Swanström LL, Perretta S, Lenglinger J, Riegler M, Dunst CM. Intraoperative assessment of esophagogastric junction distensibility during per oral endoscopic myotomy (POEM) for esophageal motility disorders. Surg Endosc. 2013;27(2):400–5.

    Article  Google Scholar 

  24. Ngamruengphong S, von Rahden BH, Filser J, Tyberg A, Desai A, Sharaiha RZ, et al. Intraoperative measurement of esophagogastric junction cross-sectional area by impedance planimetry correlates with clinical outcomes of peroral endoscopic myotomy for achalasia: a multicenter study. Surg Endosc. 2016;30(7):2886–94.

    Article  Google Scholar 

  25. Pandolfino JE, de Ruigh A, Nicodème F, Xiao Y, Boris L, Kahrilas PJ. Distensibility of the esophagogastric junction assessed with the functional lumen imaging probe (FLIP™) in achalasia patients. Neurogastroenterol Motil. 2013;25(6):496–e368.

    Article  CAS  Google Scholar 

  26. Teitelbaum EN, Soper NJ, Pandolfino JE, Kahrilas PJ, Hirano I, Boris L, et al. Esophagogastric junction distensibility measurements during Heller myotomy and POEM for achalasia predict postoperative symptomatic outcomes. Surg Endosc. 2015;29(3):522–8.

    Article  Google Scholar 

  27. Desprez C, Roman S, Leroi AM, Gourcerol G. The use of impedance planimetry (Endoscopic Functional Lumen Imaging Probe, EndoFLIP®) in the gastrointestinal tract: a systematic review. Neurogastroenterol Motil. 2020;32(9):e13980.

    Article  Google Scholar 

  28. Rohof WO, Hirsch DP, Kessing BF, Boeckxstaens GE. Efficacy of treatment for patients with achalasia depends on the distensibility of the esophagogastric junction. Gastroenterology. 2012;143(2):328–35.

    Article  Google Scholar 

  29. Sloan JA, Triggs JR, Pandolfino JE, Dbouk M, Gutierrez OIB, El Zein M, et al. Treatment experience with a novel 30-mm hydrostatic balloon in esophageal dysmotility: a multicenter retrospective analysis. Gastrointest Endosc. 2020;92(6):1251–7.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. IHU-Strasbourg, Institute of Image-Guided Surgery, Strasbourg, Alsace, France

    Margherita Pizzicannella & Silvana Perretta

  2. Department of Digestive and Endocrine Surgery, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, Alsace, France

    Margherita Pizzicannella & Silvana Perretta

  3. Research Institute against Digestive Cancer IRCAD, Strasbourg, France

    María Rita Rodríguez-Luna & Silvana Perretta

Authors
  1. Margherita Pizzicannella
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  2. María Rita Rodríguez-Luna
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  3. Silvana Perretta
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Editor information

Editors and Affiliations

  1. Division of Minimally Invasive Surgery, Center for Fluorescence-Guided Surgery, Department of Surgery, University of California San Diego, La Jolla, CA, USA

    Santiago Horgan

  2. Center for the Future of Surgery, University of California San Diego, La Jolla, CA, USA

    Karl-Hermann Fuchs

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Pizzicannella, M., Rodríguez-Luna, M.R., Perretta, S. (2021). The EndoFLIP™ System Allows a Tailored Peroral Endoscopic Myotomy (POEM) for Achalasia. In: Horgan, S., Fuchs, KH. (eds) Innovative Endoscopic and Surgical Technology in the GI Tract . Springer, Cham. https://doi.org/10.1007/978-3-030-78217-7_11

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  • DOI: https://doi.org/10.1007/978-3-030-78217-7_11

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-78216-0

  • Online ISBN: 978-3-030-78217-7

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