title: Functional lumen imaging probe to assess geometric changes in the esophagogastric junction following endolumenal fundoplication.
abstract: BACKGROUND
  The functional lumen imaging probe (FLIP) uses impedance planimetry to measure the geometry of a distensible organ. The purpose of this study was to evaluate FLIP as a method to determine structural changes at the gastroesophageal junction (GEJ) following transoral incisionless fundoplication (TIF) and compare these findings with the accepted methods of esophageal testing.
  
  
  METHODS
  Two different approaches (TIF1.0 and 2.0) using the EsophyX™ device were performed in six and five animals, respectively. Three dogs underwent a sham procedure. FLIP measurements were performed pre- and post-procedure and at 2-week follow-up. Upper endoscopy, manometry, and 48-h pH testing were also performed at each time point. FLIP was performed in ten patients before and 3 months after TIF.
  
  
  RESULTS
  Following TIF procedures, there was a significant decrease in cross-sectional area (CSA) of GEJ compared to baseline; however, the CSA of both groups returned to baseline at 2-week follow-up. The FLIP results were supported with pH testing and correlated highly with both measures of GEJ structural integrity (LES and cardia circumference). Following TIF in humans, there was a decrease in GEJ distensibility compared to baseline that persisted to the 3-month evaluation.
  
  
  CONCLUSIONS
  FLIP is able to measure and display changes in tissue distensibility at the GEJ, and results correlate with established methods of testing. FLIP may represent a single testing modality by which to diagnose GERD and evaluate the outcome after antireflux surgery.
authors: Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Shadyside Medical Center, Suite 715, 5200 Centre Avenue, Pittsburgh, PA 15232, USA.
authors: Toshitaka
authors: T
authors: Hoppo
authors: Barry P
authors: BP
authors: McMahon
authors: Bart P L
authors: BP
authors: Witteman
authors: Stefan J M
authors: SJ
authors: Kraemer
authors: Robert W
authors: RW
authors: O'Rourke
authors: Flemming
authors: F
authors: Gravesen
authors: Nicole D
authors: ND
authors: Bouvy
authors: Blair A
authors: BA
authors: Jobe
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