• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Strategic Plan, 2020-2023
    • Committees
      • Descriptions and Video Updates
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • COVID-19 Announcements
    • SAGES 2020 Meeting Information
    • 2021 Scientific Session Call For Abstracts
    • 2021 Emerging Technology Session Call For Abstracts
    • 2018 Prevent BDI Consensus Conference
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • Leadership Development and Health Policy Conference Videos
      • SAGES Quality Summit Meeting
      • SAGES 2019
      • SAGES 2018
      • SAGES 2017
      • SAGES 2016
      • SAGES 2015
      • SAGES 2014
      • SAGES 2013
    • Related Meetings Calendar
  • Membership
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • COVID-19 Annoucements
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • Troubleshooting Guides
  • Education
    • SAGES.TV Video Library
    • Virtual Hernia Clinic
    • The SAGES Safe Cholecystectomy Program
    • The Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • The SAGES HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Endorsed Courses
    • SAGES Robotics Fellows Courses
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Educational Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES Quality Initiative
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • SAGES Research Opportunities
    • SAGES Endorsed Courses
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
    • Fellowship Certification
  • Search
    • COVID-19 Announcements
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Blog
    • All Blog Posts
    • COVID-19
    • Notes from the Battlefield
    • A (Positive) Way Forward
    • President Posts
  • Log In

Electrical Stimulation Therapy (EST) of the Lower Esophageal Sphincter (LES) – An emerging therapy for refractory GERD – Preliminary Results of an International Multicenter Trial

Alex Escalona, MD, Jelle P Ruurda, MD, Mark I Van Berge Henegouwen, MD, PhD, Philip Chiu, MD

Pontificia Universidad Catolica de Chile, University Medical Center, Academic Medical Center, The Chinese University of Hong Kong

INTRODUCTION: A previous trial showed that LES-EST significantly improves esophageal acid exposure and symptoms in GERD patients. (In Press Surg Endosc)
AIMS: The aim of this international multicenter trial was to evaluate the safety and efficacy of LES-EST in refractory GERD patients.
METHODS: We studied GERD patients partially responsive to PPI with off-PPI GERD HRQL >20, LES end-expiratory pressures of >5 mmHg, % 24 hour esophageal pH<4 for >5%, hiatal hernia < 3cm and esophagitis < LA Grade C. Bipolar stitch electrodes and a pulse generator (EndoStim BV, Hague, Netherland) were implanted laparoscopically. EST at 20 Hz, 220usec, 5-8mAmp in 6-12, 30 minutes sessions was initiated post-implant. Patients are evaluated using GERD-HRQL, symptom diaries, SF-12, esophageal pH and manometry at regular intervals. Stimulation sessions are optimized based on residual symptoms and esophageal pH.
RESULTS: Thirteen patients (mean age 51; men=9) have been enrolled and implanted with the LES stimulator. One patient suffered a trocar perforation of small bowel during the implant that was recognized post-op day 1. Patient underwent successful repair and the device was prophylactically explanted. The remaining twelve patients are continuing with the LES-EST; 11 patients have completed their 3 month and 7 their 6 month evaluation. The median (IQR) off-PPI GERD-HRQL scores at baseline were 30 (24-37), which improved to 6 (4-11) on EST at months 3, (p<0.001) and 9 (7-13) at month 6 (p<0.01). There was improvement compared to the on-PPI GERD-HRQL scores of 19 (8-22) at baseline. Patients median esophageal pH was 12.4% (8.8-15) at baseline and improved to 3.6% (2-10, p=0.07) at 3 months and 4.2% (2.7-6.7, p=0.01) at 6 months. Ninety-two% (11/12) patient had > 50% improvement in their off-PPI GERD-HRQL and were able to discontinue PPI use, 83% (10/12) patients had either normalized or >50% improvement in their esophageal acid exposure. Thirteen AEs including 1 SAE were reported in 4 patients. Nine were related to the device or procedure, 7 non-severe events were pain at the implant site and 1 post-op nausea.
CONCLUSION: Preliminary results show that LES-EST can be effective in treating PPI refractory GERD. There was a significant improvement in patient’s symptom, PPI usage and trend in improvement in their esophageal acid exposure. LES-EST was safe with no GI or cardiac side-effects. Long-term results in a larger group of patients are being collected to establish safety and efficacy of LES-EST in refractory GERD.


Session: Poster Presentation

Program Number: P256

Post Views: 87

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2013 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Free SAGES Webinar: Lessons from COVID on Living and Thriving as Surgeons

SAGES recognizes that the COVID-19 pandemic has had a big impact on surgical practice and in surgeon wellness. SAGES’ Reimagining the Practice of Surgery Taskforce will present “Finding the Opportunities: Lessons from COVID and How We Live and Thrive as Surgeons”  to look at ways in which innovative leadership at various levels may help transform […]

Daniel Herron, MD

An opportunity to slow down and appreciate the small joys in life

Dan Herron, MD shares insights with Dana Telem, MD on lessons learned from COVID-19 Fear, anxiety and uncertainty has dominated the first half of 2020. Never before have we, as healthcare providers, been asked to do so much with so little—whether it’s resources like personal protective equipment, dusting off skills related to critical care, or […]

covid testing stock

Notes from the Battlefield – May 14, 2020

Coronavirus Global Surgical Collaborative (CVGSC)* An initiative sponsored by SAGES in collaboration with EAES, AEC, KSELS, and ELSA A group of surgical leaders from affected countries have joined to discuss what they are learning during this Covid-19 Global crisis. The following is a brief summary of what they feel may be useful information to disseminate to the surgical […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Newsletter Subscription

  • This field is for validation purposes and should be left unchanged.

Important Links

SAGES 2020 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

[footer_backtotop] · Log in

Copyright © 2021 Society of American Gastrointestinal and Endoscopic Surgeons · Legal
· Managed by BSC Management, Inc