Swedish Medical Center & SurgOne, P.C, 400 W Hampden Place, Suite 230, Englewood, CO 80110, USA.
Surg Endosc. 2011 Jul;25(7):2387-99. doi: 10.1007/s00464-010-1528-6. Epub 2010 Dec 24.
Gastroesophageal reflux disease (GERD) results primarily from the loss of an effective antireflux barrier, which forms a mechanical barrier against the retrograde movement of gastric content. Restoration of the incompetent antireflux barrier is possible by longitudinal and rotational advancement of the gastric fundus about the lower esophagus, creating an esophagogastric fundoplication. This article describes the technique of performing a rotational and longitudinal esophagogastric fundoplication, performed transorally using EsophyX.
The transoral incisionless fundoplication (TIF) technique enables the creation of a full-thickness esophagogastric fundoplication with fixation extending longitudinally up to 3.5 cm above the Z-line and rotationally more than 270 degrees around the esophagus. A key element of the technique involves rotating the fundus around the esophagus with a tissue mold during gastric desufflation. Anatomic considerations and use of the device's tissue invaginator to push the esophagus caudally are important to ensure safe positioning of the plications below the diaphragm. The steps of the technique are described in detail, and suggestions are given about patient selection and care, as well as prevention and management of complications.
胃食管反流病（GERD）主要是由于有效的抗反流屏障丧失引起的，该屏障形成了阻止胃内容物逆行运动的机械屏障。通过胃底在食管下段的纵向和旋转推进，可以重建功能不全的抗反流屏障，从而形成胃食管折叠术。本文描述了使用 EsophyX 通过经口进行旋转和纵向胃食管折叠术的技术。
经口无切口的胃底折叠术（TIF）技术可实现全层胃食管折叠术，固定范围向上延伸至 Z 线以上 3.5 厘米，旋转超过食管 270 度。该技术的一个关键要素是在胃排空时用组织模具围绕食管旋转胃底。解剖学考虑因素以及使用器械的组织内陷器将食管推向尾侧对于确保折叠在膈肌下方安全定位至关重要。详细描述了该技术的步骤，并就患者选择和护理以及并发症的预防和管理提出了建议。
