Diagnostic and therapeutic technology assessment. Angelchik antireflux prosthesis.
In summary, the DATTA panelists felt that the Angelchik prosthesis is effective in relieving gastroesophageal reflux and that the device, along with other types of surgical procedures, is indicated when medical management has failed and when objective evidence of incompetence of the lower esophageal sphincter is present. Because the procedure is rapid and requires little dissection, it might be most useful in the elderly and high-risk patient. Notwithstanding such support from the DATTA panelists for the device's efficacy, the majority of DATTA panelists felt that concerns about the safety of the device compromise its clinical utility. Such concern arose from past reports of complications and the panelists' own experience with migration or erosion of the device. Thus, these panelists could not recommend the device's routine use. Additionally, some DATTA panelists considered the development of the Angelchik prosthesis to be unnecessary, as standard surgical techniques, eg, fundoplication, give adequate results. The improved safety statistics reported since 1982 may remove some of these reservations in the future.
D000574:American Medical Association; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D019736:Prostheses and Implants / Q000009:adverse effects; D013673:Technology Assessment, Biomedical; D014481:United States